Peptides for the Treatment of Hearing

ABSTRACT

Peptides for the treatment of inflammation, and therapeutic uses and methods of using the same are disclosed. Peptides including a transducing sequence are effective for inhibiting cytokine activity and TNF-α secretion through interaction with toll-like receptor signaling pathways. Experiments are described illustrating the efficacy of the compounds in treating otitis media, noise-induced hearing loss, age-related hearing loss, and improvement of ordinary hearing.

CROSS REFERENCE

This application claims priority from U.S. Provisional Application No. 61/472,301, filed on Apr. 6, 2011; U.S. Provisional Application No. 61/472,300, filed on Apr. 6, 2011; U.S. Provisional Application No. 61/472,307, filed on Apr. 6, 2011; U.S. Provisional Application No. 61/472,306, filed on Apr. 6, 2011; U.S. Provisional Application No. 61/472,311, filed on Apr. 6, 2011; and U.S. Provisional Application No. 61/472,309, filed on Apr. 6, 2011, each of which is incorporated by reference herein in its entirety.

STATEMENT AS TO FEDERALLY SPONSORED RESEARCH

The invention was made with the support of the United States government under Small Business innovation Research Contract number 5R44DC005882-05 by the U.S. Small Business Administration.

SEQUENCE LISTING

The instant application contains a Sequence Listing which has been submitted in ASCII format via EFS-Web and is hereby incorporated by reference in its entirety. The ASCII copy, created on Apr. 4, 2012, is named 37501201.txt and is 122,035 bytes in size.

BACKGROUND OF THE INVENTION

Toll-like receptors (TLRs) recognize and respond to conserved motifs termed “pathogen-associated molecular patterns” (PAMPs). TLRs are characterized by an extracellular leucine-rich repeat motif and an intracellular Toll/IL-1 receptor (TIR) domain. Triggering of TLRs by PAMPs initiates a series of intracellular signaling events resulting in an inflammatory immune response designed to contain and eliminate the pathogen. Viruses encode immunoregulatory proteins, such as A52R (produced by the vaccina virus), that can effectively inhibit intracellular TIR signaling resulting in a diminished inflammatory immune response.

Noise induced hearing loss is the second most common cause of hearing loss. Noise can damage the hair cells in the inner ear and can cause hearing loss, ear ringing and distortion of sounds. Similarly, tissue damage related to aging can cause or exacerbate hearing loss in animals.

SUMMARY OF THE INVENTION

A method of treating noise-induced hearing loss, or treating age-related hearing loss, or improving hearing, the method comprising administering to a subject in need or want of any of the foregoing a therapeutically-effective amount ofa peptide that is:

a) a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

-   -   each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl         group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an         aminocarbonyl group, or both cap^(N) groups together with N form         a heterocycle;     -   tran^(N) and tran^(C) are each independently a transducing         sequence or absent;     -   pep^(N) and pep^(C) are each independently an amino acid         sequence or absent;     -   X¹ is A, K, an acidic amino acid residue, or is absent;     -   X² is A, I, L, or V;     -   X³ is A, D, I, L, P, or V;     -   X⁴ is A, E, I, Y, or a basic amino acid residue;     -   X⁵ is A, I, L, or V;     -   X⁶ is A, G, S, T, or Y;     -   X⁷ is A, E, I, L, or V;     -   X⁸ is A, P, S, T, or an aromatic amino acid residue;     -   X⁹ is A, K, or an acidic amino acid residue;     -   X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline;     -   X¹¹ A is A, I, L, V, or is absent;     -   X¹² is G or is absent;     -   x is 1, 2, or 3;     -   cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino,         dialkylamino, or a heterocycle; and     -   each amino acid residue side chain is independently optionally         capped with a capping group; or

b) a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, and wherein the peptide optionally further comprises a transducing sequence positioned at the C-terminus of the peptide,

or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing peptides.

DESCRIPTION OF THE FIGURES

FIG. 1: Illustrates an assay for crossing the tympanic membrane by FITC-labeled P13. FIG. 1A. Bright field microscopy demonstrates cells in middle ear fluid.

FIG. 1B. Fluorescent microscopy demonstrates FITC-labeled P13 associated with cells in middle ear fluid.

FIG. 2: P13 (SEQ ID NO: 369) reduces middle ear inflammation. BALB/c mice (n=6 in PBS group and n=7 in P13 (SEQ ID NO: 369) group) were injected with heat-killed S. pneumonia, treated 24 hours later with topical (ear drop) administration of P13 (SEQ ID NO: 369) (1 μg), and histology was examined 72 hours after bacteria introduction. Panel A: cell number within middle ear; Panel B: fluid area within middle ear. Note: Animal with high cell number and high fluid area in the P13 (SEQ ID NO: 369) treated group is the same animal.

FIG. 3: Topical administration of P13 (SEQ ID NO: 369) significantly improves hearing thresholds. BALB/c mice were administered heat-killed S. pneumonia, 24 hours later mice were treated topically (ear drops) with P13 (SEQ ID NO: 369) (1 μg) or PBS. Panel A: Hearing thresholds at 4, 8, 16 and 32 kHz were quantified by ABR at days 5 and 13 days after administration of bacteria. Hearing loss was calculated by subtracting the background ABR from post-treatment ABR and summing across frequencies. Panel B: Number of animals with >20 DB hearing loss across all frequencies. Number of animals is in parentheses.

FIG. 4: Percent Inhibition of TNF-α secretion by peptides T52 (SEQ ID NO: 368), S5 (SEQ ID NO: 255) and P13 (SEQ ID NO: 369). RAW264.7 cells were plated at 3×10⁵ cells/well in 48-well plates. After 24 h the cells were incubated with peptide at various concentrations at room temperature in triplicate for 15 minutes and then stimulated with 1 μg/mL CpG-ODN. Cells were then incubated for 4 hours at 37° C., supernatants collected, and TNF-α measured by ELISA. Percent inhibition was calculated by comparing TNF-α secretion from cells incubated with peptide to control cells with no peptide treatment.

FIG. 5: Illustrates the affect of P13 (SEQ ID NO: 369) and a control peptide on noise-induced hearing loss.

FIG. 6: Illustrates the inhibition of TNF-α production in necrotic cell extract-stimulated cells by P13 (SEQ ID NO: 369) and P7 (SEQ ID NO: 379).

FIG. 7: Illustrates the affect of P13 (SEQ ID NO: 369) on age-related hearing loss in C57Bl/6 mice.

FIG. 8: Illustrates the improvement of ordinary hearing in BALB/c mice upon treatment with P13 (SEQ ID NO: 369).

INCORPORATION BY REFERENCE

All publications, patents, and patent applications mentioned in this specification are incorporated by reference herein to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference.

DETAILED DESCRIPTION OF THE INVENTION

The treatment and control of natural and pathogen-induced inflammation represents a significant clinical challenge. The targeting of the TLR/TIR signaling cascade represents one approach to control inflammation; thus the identification of peptides derived from the A52R protein or A52R-like proteins finds therapeutic applications. The peptides and pharmaceutical compositions of the invention disclosed herein, and uses and methods of using the same, present a solution to the problem of controlling inflammation, regulating cellular pathways associated with inflammation, ameliorating noise-induced and age-related hearing loss, and improving normal hearing. Peptides described herein can be useful for treating, preventing, or both treating and preventing the conditions described herein.

Throughout the disclosure, amino acid residues of the peptides of the invention are referenced by one or both of the standard abbreviations known in the art: a) single-letter abbreviations, such as R for arginine, D for aspartic acid, V for valine, etc.; and b) three-letter abbreviations, such as Arg for arginine, Asp for aspartic acid, Val for valine, etc. The invention contemplates both L- and D-forms of amino acid residues. In cases wherein the abbreviation refers only to an amino acid residue of the D-configuration, the abbreviation is preceded by the term, “D-,” for example, D-Arg for D-arginine, D-Asp for D-aspartic acid, D-Val for D-valine, etc.

Toll-Like Receptor Signaling

Toll-Like receptors (“TLRs”) are conserved molecular receptors that recognize structures from bacteria, fungi, protozoa, and viruses. Activation of TLRs initiates a series of intracellular events resulting in an innate immune response characterized by the production of pro-inflammatory cytokines (References 2-9). TLR signaling originates from the cytoplasmic Toll/interleukin-1 receptor (TIR) domain, conserved among all TLRs. Not limited by any theory, in certain embodiments, adapter molecule MyD88, containing both a TIR domain and a death domain, can associate with the TIR domain of TLRs and IRAK proteins. Phosporylation of IRAK can then lead to association with TRAF6 and subsequent activation of NF-κB and secretion of pro-inflammatory cytokines (References 14, 22-25).

Peptides

Vaccinia virus, a member of the poxvirus family, is a DNA virus that has been demonstrated to encode immunomodulatory proteins (References 15-18). One of these proteins, A52R, has been shown to inhibit NF-κB activation following initiation of the TIR signaling cascade (References 15 and 18). Recent studies have demonstrated that A52R inhibits TR signaling and contributes to the virulence of vaccinia virus. In certain embodiments, cell activation in response to different PAMPs involves a number of intracellular molecules common to all TLRs, including but not limited to MyD88, members of the IL-1 receptor-associated kinase (IRAK) proteins, TNF receptor associated factor (TRAF6), and NF-κB (Reference 1).

Harte and colleagues (Reference 18) have demonstrated that the A52R protein inhibits TIR signaling by binding to both IRAK2 and TRAF6. Deletion of the A52R protein from vaccinia virus results in reduced viral virulence.

The peptide 13 (“P13”) sequence (DIVKLTVYDCI (SEQ ID NO: 369)) was derived from the A52R sequence from vaccinia virus. Blast search analysis shows that peptide P13 (SEQ ID NO: 369) has 100% homology with sequences found within larger proteins from vaccinia virus other than A52R, two proteins from cowpox virus, and one protein from rabbit pox virus. Peptide 13 (SEQ ID NO: 369) was shown to have significant homology with three separate proteins from different strains of variola (smallpox) virus: i) A46L from variola major virus strain India; ii) A49L from variola minor virus Garcia; and iii) A44L from variola major virus strain.

P13 (SEQ ID NO: 369) inhibits toll-like receptor-dependent signaling (U.S. Pat. No. 7,192,930 and US2008/0039395 incorporated herein by reference in their entirety). In some embodiments, structure-activity testing can be performed to identify amino acid residues in the P13 (SEQ ID NO: 369) sequence that can be substituted for enhanced activity.

In some embodiments, the present invention provides a pharmaceutical composition comprising a peptide derived from A52R. In some embodiments, the pharmaceutical composition is an aural pharmaceutical composition.

In some embodiments, the peptide is P13 (SEQ ID NO: 369). In some embodiments, the peptide is derived from P13 (SEQ ID NO: 369). In some embodiments, the peptide is a P13 (SEQ ID NO: 369) variant, derivative, stereoisomer, or analogue. In some embodiments, the peptide comprises the amino acid sequence LEEYFMY (SEQ ID NO: 370). In some embodiments, the peptide comprises the amino acid sequence FTILEEYFMY (SEQ ID NO: 371). In some embodiments, the peptide comprises the amino acid sequence DIVKLTVYDCI (SEQ ID NO: 369). In some embodiments, the peptide comprises the amino acid sequence VYDCI (SEQ ID NO: 372). In some embodiments, the peptide comprises the amino acid sequence VYACI (SEQ ID NO: 373). In some embodiments, the peptide comprises the amino acid sequence KLTVY (SEQ ID NO: 374). In some embodiments, the peptide comprises the amino acid sequence KLYVY (SEQ ID NO: 375). In some embodiments, the peptide comprises the amino acid sequence KVYVY (SEQ ID NO: 376). In some embodiments, the peptide comprises 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, or 50 residues. In some embodiments, the peptide comprises from about 4 to about 50 residues. In some embodiments, the peptide comprises from 4-50 residues.

In some embodiments, a peptide comprises a transducing sequence. The transducing sequence can participate in cellular uptake. The presence of the transducing sequence can lead to enhanced or selective cellular uptake. In some embodiments, the transducing sequence is at the N-terminus of the peptide. In some embodiments, the transducing sequence is at the C-terminus of the peptide.

A non-limiting example of a transducing sequence is a poly-arginine sequence. In some embodiments, the poly-arginine sequence comprises arginine residues. In some embodiments, the poly-arginine sequence consists of arginine residues. In some embodiments, the transducing sequence comprises 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19 or 20 arginine residues. In some embodiments, the transducing sequence comprises nine arginine residues. In some embodiments, the transducing sequence comprises nine arginine residues. In some embodiments, the transducing sequence consists of about nine arginine residues. In some embodiments, the transducing sequence consists of nine arginine residues. The arginine residues of the transducing sequence can be L-arginine, D-arginine, or a mixture of L- and D-arginine in any proportion.

Table 1 provides non-limiting examples of peptides of the invention. Exemplary peptides SEQ ID NOS 187-316 are those derived from A52R. Of peptides SEQ ID NOs 187-316, a subset is further designated S1-S22 (SEQ ID NOs: 228-230; 254-263; 265-267; 269; and 288-292). Other examples include peptides derived from P13 (SEQ ID NO: 369) (“T peptides”). In some embodiments, the present invention provides a pharmaceutical composition comprising a peptide comprising any amino acid sequence listed in Table 1. In some embodiments, the present invention provides a pharmaceutical composition comprising any peptide listed in Table 1. In some embodiments, the present invention provides a pharmaceutical composition comprising a peptide comprising any amino acid sequence of S1-S22 (SEQ ID NOs: 228-230; 254-263; 265-267; 269; and 288-292). In some embodiments, the present invention provides a pharmaceutical composition comprising any peptide of S1-S22 (SEQ ID NOs: 228-230; 254-263; 265-267; 269; and 288-292). In some embodiments, the present invention provides a pharmaceutical composition comprising a peptide comprising any amino acid sequence of T1-T56 (SEQ ID NOs: 183-186; and 317-368). In some embodiments, the present invention provides a pharmaceutical composition comprising any peptide of T1-T56 (SEQ ID NOs: 183-186; and 317-368). In some embodiments, the peptide has a transducing sequence. In some embodiments, the transducing sequence is poly-arginine. In some embodiments, the peptide comprises the sequence of any one of SEQ ID NOS: 42-44, 68-77, 79-81, 83, 102-106, 133, 141, 151, 166, 167, 181, 182, 228-230, 254-263, 265-267, 269, 288-292, 319, 327, 337, 352, 353, 367, and 368. In some embodiments, the peptide comprises the sequence of T3 (SEQ ID NO: 319), T11 (SEQ ID NO: 327), T21 (SEQ ID NO: 337), T36 (SEQ ID NO: 352), T37 (SEQ ID NO: 353), T51 (SEQ ID NO: 367), or T52 (SEQ ID NO: 368). In some embodiments, the peptide comprises the sequence of T3-R⁹ (SEQ ID NO: 133), T11-R⁹ (SEQ ID NO: 141), T21-R⁹ (SEQ ID NO: 151), T36-R⁹ (SEQ ID NO: 166), T37-R⁹ (SEQ ID NO: 167), T51-R⁹ (SEQ ID NO: 181), or T52-R⁹ (SEQ ID NO: 182). In some embodiments, a peptide of the invention has a sequence comprising any one of SEQ ID NOS: 1-369 and 378-396. In some embodiments, a peptide of the invention has a sequence comprising any amino acid sequence contemplated herein. Any of the forgoing peptides and pharmaceutical compositions thereof can be used for the treatment of a condition, for example, noise-induced hearing loss or age-related hearing loss. The same peptides can also be used for the improvement of normal hearing.

TABLE 1 Exemplary peptides of the invention Peptide Sequence   1-R⁹ YIKVQKQDIVKLTVYDCISMIGLCARRRRRRRRR (SEQ ID NO: 1)   2-R⁹ IKVQKQDIVKLTVYDCISMIGLCARRRRRRRRR (SEQ ID NO: 2)   3-R⁹ KVQKQDIVKLTVYDCISMIGLCARRRRRRRRR (SEQ ID NO: 3)   4-R⁹ VQKQDIVKLTVYDCISMIGLCARRRRRRRRR (SEQ ID NO: 4)   5-R⁹ QKQDIVKLTVYDCISMIGLCARRRRRRRRR (SEQ ID NO: 5)   6-R⁹ KQDIVKLTVYDCISMIGLCARRRRRRRRR (SEQ ID NO: 6)   7-R⁹ QDIVKLTVYDCISMIGLCARRRRRRRRR (SEQ ID NO: 7)   8-R⁹ DIVKLTVYDCISMIGLCARRRRRRRRR (SEQ ID NO: 8)   9-R⁹ IVKLTVYDCISMIGLCARRRRRRRRR (SEQ ID NO: 9)  10-R⁹ VKLTVYDCISMIGLCARRRRRRRRR (SEQ ID NO: 10)  11-R⁹ KLTVYDCISMIGLCARRRRRRRRR  (SEQ ID NO: 11)  12-R⁹ LTVYDCISMIGLCARRRRRRRRR (SEQ ID NO: 12)  13-R⁹ TVYDCISMIGLCARRRRRRRRR  (SEQ ID NO: 13)  14-R⁹ VYDCISMIGLCARRRRRRRRR  (SEQ ID NO: 14)  15-R⁹ YDCISMIGLCARRRRRRRRR  (SEQ ID NO: 15)  16-R⁹ DCISMIGLCARRRRRRRRR  (SEQ ID NO: 16)  17-R⁹ CISMIGLCARRRRRRRRR (SEQ ID NO: 17)  18-R⁹ ISMIGLCARRRRRRRRR (SEQ ID NO: 18)   19-R⁹ SMIGLCARRRRRRRRR (SEQ ID NO: 19)  20-R⁹ MIGLCARRRRRRRRR (SEQ ID NO: 20)  21-R⁹ IGLCARRRRRRRRR (SEQ ID NO: 21)  22-R⁹ YIKVQKQDIVKLTVYDCISMIGLCRRRRRRRRR  (SEQ ID NO: 22)  23-R⁹ YIKVQKQDIVKLTVYDCISMIGLRRRRRRRRR  (SEQ ID NO: 23)  24-R⁹ YIKVQKQDIVKLTVYDCISMIGRRRRRRRRR  (SEQ ID NO: 24)  25-R⁹ YIKVQKQDIVKLTVYDCISMIRRRRRRRRR  (SEQ ID NO: 25)  26-R⁹ YIKVQKQDIVKLTVYDCISMRRRRRRRRR  (SEQ ID NO: 26)  27-R⁹ YIKVQKQDIVKLTVYDCISRRRRRRRRR  (SEQ ID NO: 27)  28-R⁹ YTKVQKQDIVKLTVYDCIRRRRRRRRR  (SEQ ID NO: 28)  29-R⁹ YIKVQKQDIVKLTVYDCRRRRRRRRR  (SEQ ID NO: 29)  30-R⁹ YIKVQKQDIVKLTVYDRRRRRRRRR  (SEQ ID NO: 30)  31-R⁹ YIKVQKQDIVKLTVYRRRRRRRRR  (SEQ ID NO: 31)  32-R⁹ YIKVQKQDIVKLTVRRRRRRRRR  (SEQ ID NO: 32)  33-R⁹ YIKVQKQDIVKLTRRRRRRRRR  (SEQ ID NO: 33)  34-R⁹ YTKVQKQDIVKLRRRRRRRRR (SEQ ID NO: 34)  35-R⁹ YIKVQKQDIVKRRRRRRRRR (SEQ ID NO: 35)  36-R⁹ YIKVQKQDIVRRRRRRRRR (SEQ ID NO: 36)  37-R⁹ YIKVQKQDIRRRRRRRRR (SEQ ID NO: 37)  38-R⁹ YIKVQKQDRRRRRRRRR (SEQ ID NO: 38)   39-R⁹ YIKVQKQRRRRRRRRR (SEQ ID NO: 39)  40-R⁹ YTKVQKRRRRRRRRR (SEQ ID NO: 40)  41-R⁹ YIKVQRRRRRRRRR (SEQ ID NO: 41)  42(S1)-R⁹ EMFTILEEYFMYRGLLGLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 42)  43(S2)-R⁹ MFTILEEYFMYRGLLGLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 43)  44(S3)-R⁹ FTILEEYFMYRGLLGLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 44)  45-R⁹ TILEEYFMYRGLLGLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 45)  46-R⁹ ILEEYFMYRGLLGLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 46)  47-R⁹ LEEYFMYRGLLGLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 47)  48-R⁹ EEYFMYRGLLGLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 48)  49-R⁹ EYFMYRGLLGLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 49)  50-R⁹ YFMYRGLLGLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 50)  51-R⁹ FMYRGLLGLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 51)  52-R⁹ MYRGLLGLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 52)  53-R⁹ YRGLLGLRIKYGRLFNETRRRRRRRRR  (SEQ ID NO: 53)  54-R⁹ RGLLGLRIKYGRLFNETRRRRRRRRR  (SEQ ID NO: 54)  55-R⁹ GLLGLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 55)  56-R⁹ LLGLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 56)  57-R⁹ LGLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 57)  58-R⁹ GLRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 58)  59-R⁹ LRIKYGRLFNEIRRRRRRRRR  (SEQ ID NO: 59)  60-R⁹ RIKYGRLFNEIRRRRRRRRR (SEQ ID NO: 60)  61-R⁹ IKYGRLFNETRRRRRRRRR (SEQ ID NO: 61)  62-R⁹ KYGRLFNEIRRRRRRRRR (SEQ ID NO: 62)  63-R⁹ YGRLFNEIRRRRRRRRR (SEQ ID NO: 63)  64-R⁹ GRLFNEIRRRRRRRRR (SEQ ID NO: 64)  65-R⁹ RLFNEIRRRRRRRRR (SEQ ID NO: 65)  66-R⁹ LFNEIRRRRRRRRR (SEQ ID NO: 66)  67-R⁹ EMFTILEEYFMYRGLLGLRIKYGRLFNERRRRRRRRR  (SEQ ID NO: 67)  68(S4)-R⁹ EMFTILEEYFMYRGLLGLRIKYGRLFNRRRRRRRRR  (SEQ ID NO: 68)  69(S5)-R⁹ EMFTILEEYFMYRGLLGLRIKYGRLFRRRRRRRRR  (SEQ ID NO: 69)  70(S6)-R⁹ EMFTILEEYFMYRGLLGLRIKYGRLRRRRRRRRR  (SEQ ID NO: 70)  71(S7)-R⁹ EMFTILEEYFMYRGLLGLRIKYGRRRRRRRRRR  (SEQ ID NO: 71)  72(S8)-R⁹ EMFTILEEYFMYRGLLGLRIKYGRRRRRRRRR  (SEQ ID NO: 72)  73(S9)-R⁹ EMFTILEEYFMYRGLLGLRIKYRRRRRRRRR  (SEQ ID NO: 73)  74(S10)-R⁹ EMFTILEEYFMYRGLLGLRIKRRRRRRRRR  (SEQ ID NO: 74)  75(S11)-R⁹ EMFTILEEYFMYRGLLGLRIRRRRRRRRR  (SEQ ID NO: 75)  76(S12)-R⁹ EMFTILEEYFMYRGLLGLRRRRRRRRRR  (SEQ ID NO: 76)  77(S13)-R⁹ EMFTILEEYFMYRGLLGLRRRRRRRRR  (SEQ ID NO: 77)  78-R⁹ EMFTILEEYFMYRGLLGRRRRRRRRR  (SEQ ID NO: 78)  79(S14)-R⁹ EMFTILEEYFMYRGLLRRRRRRRRR  (SEQ ID NO: 79)  80(S15)-R⁹ EMFTILEEYFMYRGLRRRRRRRRR  (SEQ ID NO: 80)  81(S16)-R⁹ EMFTILEEYFMYRGRRRRRRRRR  (SEQ ID NO: 81)  82-R⁹ EMFTILEEYFMYRRRRRRRRRR (SEQ ID NO: 82)  83(S17)-R⁹ EMFTILEEYFMYRRRRRRRRR (SEQ ID NO: 83)  84-R⁹ EMFTILEEYFMRRRRRRRRR (SEQ ID NO: 84)  85-R⁹ EMFTILEEYFRRRRRRRRR (SEQ ID NO: 85)  86-R⁹ EMFTILEEYRRRRRRRRR (SEQ ID NO: 86)  87-R⁹ EMFTILEERRRRRRRRR (SEQ ID NO: 87)  88-R⁹ EMFTILERRRRRRRRR (SEQ ID NO: 88)  89-R⁹ EMFTILRRRRRRRRR (SEQ ID NO: 89)  90-R⁹ EMFTIRRRRRRRRR (SEQ ID NO: 90)  91-R⁹ MFTILLEEYFMYRGLLRRRRRRRRR  (SEQ ID NO: 91)  92-R⁹ FTILLEEYFMYRGLLRRRRRRRRR  (SEQ ID NO: 92)  93-R⁹ TILLEEYFMYRGLLRRRRRRRRR  (SEQ ID NO: 93)  94-R⁹ ILLEEYFMYRGLLRRRRRRRRR  (SEQ ID NO: 94)  95-R⁹ LLEEYFMYRGLLRRRRRRRRR (SEQ ID NO: 95)  96-R⁹ LEEYFMYRGLLRRRRRRRRR (SEQ ID NO: 96)  97-R⁹ EYFMYRGLLRRRRRRRRR (SEQ ID NO: 97)  98-R⁹ YFMYRGLLRRRRRRRRR (SEQ ID NO: 98)  99-R⁹ FMYRGLLRRRRRRRRR (SEQ ID NO: 99) 100-R⁹ MYRGLLRRRRRRRRR (SEQ ID NO: 100) 101-R⁹ YRGLLRRRRRRRRR(SEQ ID NO: 101) 102(S18)-R⁹ MFTILEEYFMYRGLLGLRIRRRRRRRRR  (SEQ ID NO: 102) 103(S19)-R⁹ FTILEEYFMYRGLLGLRIRRRRRRRRR  (SEQ ID NO: 103) 104(S20)-R⁹ TILEEYFMYRGLLGLRIRRRRRRRRR  (SEQ ID NO: 104) 105(S21)-R⁹ ILEEYFMYRGLLGLRIRRRRRRRRR  (SEQ ID NO: 105) 106(S22)-R⁹ LEEYFMYGLLGLRIRRRRRRRRR  (SEQ ID NO: 106) 107-R⁹ EYFMYRGLLGLRIKYGRRRRRRRRR  (SEQ ID NO: 107) 108-R⁹ YFMYRGLLGLRIKYGRRRRRRRRR  (SEQ ID NO: 108) 109-R⁹ FMYRGLLGLRIKYGRRRRRRRRR  (SEQ ID NO: 109) 110-R⁹ MYRGLLGLRIKYGRRRRRRRRR (SEQ ID NO: 110) 111-R⁹ YRGLLGLRIKYGRRRRRRRRR (SEQ ID NO: 111) 112-R⁹ RGLLGLRIKYGRRRRRRRRR (SEQ ID NO: 112) 113-R⁹ GLLGLRIKYGRRRRRRRRR (SEQ ID NO: 113) 114-R⁹ LLGLRIKYGRRRRRRRRR (SEQ ID NO: 114) 115-R⁹ LGLRIKYGRRRRRRRRR (SEQ ID NO: 115) 116-R⁹ GLRIKYGRRRRRRRRR (SEQ ID NO: 116) 117-R⁹ LRIKYGRRRRRRRRR (SEQ ID NO: 117) 118-R⁹ RIKYGRRRRRRRRR (SEQ ID NO: 118) 119-R⁹ EEYFMRRRRRRRRR (SEQ ID NO: 119) 120-R⁹ EEYFMYRRRRRRRRR (SEQ ID NO: 120) 121-R⁹ EEYFMYRRRRRRRRRR (SEQ ID NO: 121) 122-R⁹ EEYFMYRGRRRRRRRRR (SEQ ID NO: 122) 123-R⁹ EEYFMYRGLRRRRRRRRR (SEQ ID NO: 123) 124-R⁹ EEYFMYRGLLRRRRRRRRR (SEQ ID NO: 124) 125-R⁹ EEYFMYRGLLGRRRRRRRRR (SEQ ID NO: 125) 126-R⁹ EEYFMYRGLLGLRRRRRRRRR (SEQ ID NO: 126) 127-R⁹ EEYFMYRGLLGLRRRRRRRRRR (SEQ ID NO: 127) 128-R⁹ EEYFMYRGLLGLRIRRRRRRRRR (SEQ ID NO: 128) 129-R⁹ EEYFMYRGLLGLRIKRRRRRRRRR  (SEQ ID NO: 129) 130-R⁹ EEYFMYRGLLGLRIKYRRRRRRRRR  (SEQ ID NO: 130)  T1-R⁹ IVKLTVYDCIRRRRRRRRR (SEQ ID NO: 131)  T2-R⁹ DIVKLTVYDCRRRRRRRRR (SEQ ID NO: 132)  T3-R⁹ AIVKLTVYDCIRRRRRRRRR (SEQ ID NO: 133)  T4-R⁹ DAVKLTVYDCIRRRRRRRRR (SEQ ID NO: 134)  T5-R⁹ DIAKLTVYDCIRRRRRRRRR (SEQ ID NO: 135)  T6-R⁹ DIVALTVYDCIRRRRRRRRR (SEQ ID NO: 136)  T7-R⁹ DIVKATVYDCIRRRRRRRRR (SEQ ID NO: 137)  T8-R⁹ DIVKLAVYDCIRRRRRRRRR (SEQ ID NO: 138)  T9-R⁹ DIVKLTAYDCIRRRRRRRRR (SEQ ID NO: 139) T10-R⁹ DIVKLTVADCIRRRRRRRRR (SEQ ID NO: 140) T11-R⁹ DIVKLTVYACIRRRRRRRRR (SEQ ID NO: 141) T12-R⁹ DIVKLTVYDAIRRRRRRRRR (SEQ ID NO: 142) T13-R⁹ DIVKLTVYDCARRRRRRRRR (SEQ ID NO: 143) T14-R⁹ EIVKLTVYDCIRRRRRRRRR (SEQ ID NO: 144) T15-R⁹ DIVKLTVYECIRRRRRRRRR (SEQ ID NO: 145) T16-R⁹ DIVRLTVYDCIRRRRRRRRR (SEQ ID NO: 146) T17-R⁹ DIVHLTVYDCIRRRRRRRRR (SEQ ID NO: 147) T18-R⁹ KIVKLTVYKCIRRRRRRRRR (SEQ ID NO: 148) T19-R⁹ DIVELTVYDCIRRRRRRRRR (SEQ ID NO: 149) T20-R⁹ DIVKLSVYDCIRRRRRRRRR (SEQ ID NO: 150) T21-R⁹ DIVKLYVYDCIRRRRRRRRR (SEQ ID NO: 151) T22-R⁹ DIVKLTVSDCIRRRRRRRRR (SEQ ID NO: 152) T23-R⁹ DIVKLTVTDCIRRRRRRRRR (SEQ ID NO: 153) T24-R⁹ DIVKLTVWDCIRRRRRRRRR (SEQ ID NO: 154) T25-R⁹ DIVKLTVFDCIRRRRRRRRR (SEQ ID NO: 155) T26-R⁹ DIVKLTVYDMIRRRRRRRRR (SEQ ID NO: 156) T27-R⁹ DIVKLTVYDSIRRRRRRRRR (SEQ ID NO: 157) T28-R⁹ DIVKLTVYDXaaIRRRRRRRRR (SEQ ID NO: 158) T29-R⁹ DIVKLTVYDXaaIRRRRRRRRR (SEQ ID NO: 159) T30-R⁹ DIVKLTVYDXaaIRRRRRRRRR (SEQ ID NO: 160) T31-R⁹ DIVKLTVYDXaaIRRRRRRRRR (SEQ ID NO: 161) T32-R⁹ DIVKLTVYDXaaIRRRRRRRRR (SEQ ID NO: 162) T33-R⁹ DLVKLTVYDCIRRRRRRRRR (SEQ ID NO: 163) T34-R⁹ DVVKLTVYDCIRRRRRRRRR (SEQ ID NO: 164) T35-R⁹ DILKLTVYDCIRRRRRRRRR (SEQ ID NO: 165) T36-R⁹ DIIKLTVYDCIRRRRRRRRR (SEQ ID NO: 166) T37-R⁹ DIVKVTVYDCIRRRRRRRRR (SEQ ID NO: 167) T38-R⁹ DIVKITVYDCIRRRRRRRRR (SEQ ID NO: 168) T39-R⁹ DIVKLTLYDCIRRRRRRRRR (SEQ ID NO: 169) T40-R⁹ DIVKLTIYDCIRRRRRRRRR (SEQ ID NO: 170) T41-R⁹ DIVKLTVYDCLRRRRRRRRR (SEQ ID NO: 171) T42-R⁹ DIVKLTVYDCVRRRRRRRRR (SEQ ID NO: 172) T43-R⁹ DIDKLTEYDSIRRRRRRRRR (SEQ ID NO: 173) T44-R⁹ DIPKLGVPDCIRRRRRRRRR (SEQ ID NO: 174) T45-R⁹ ICDYVTLKVIDRRRRRRRRR (SEQ ID NO: 175) T46-R⁹ VDLVIDCIYKTRRRRRRRRR (SEQ ID NO: 176) T47-R⁹ DIVKLTVYDCIDIVKLTVYDCIRRRRRRRRR  (SEQ ID NO: 177) T48-R⁹ IVKLTVYDCIRRRRRRRRR (N-succinyl)  (SEQ ID NO: 178) T49-R⁹ DIVKLTVYDCIGRRRRRRRRR (SEQ ID NO: 179) T50-R⁹ DIVKLTVYDCIRRRRRRRRR (N-acetyl)  (SEQ ID NO: 180) T51-R⁹ AIVKLTVYACIRRRRRRRRR (SEQ ID NO: 181) T52-R⁹ AIIKVYVYACIRRRRRRRRR (SEQ ID NO: 182) T53 D-Asp-D-Ile-D-Val-D-Lys-D-Leu-D-Thr- D-Val-D-Tyr-D-Asp-D-Cys-D-Ile-Arg- Arg-Arg-Arg-Arg-Arg-Arg-Arg-Arg (SEQ ID NO: 183) T54 D-Asp-D-Ile-D-Val-D-Lys-D-Leu- D-Thr-D-Val-D-Tyr-D-Asp-D-Cys-   D-Ile-D-Arg-D-Arg-D-Arg-D-Arg- D-Arg-D-Arg-D-Arg-D-Arg-D-Arg  (SEQ ID NO: 184) T55 D-Asp-D-Ile-D-Val-D-Lys-D-Leu- D-Thr-D-Val-D-Tyr-D-Asp-D-Cys- D-Ile (SEQ ID NO: 185) T56 Asp-Ile-Val-Lys-Leu-Thr-Val-Tyr-Asp- Cys-Ile-D-Arg-D-Arg-D-Arg-D-Arg- D-Arg-D-Arg-D-Arg-D-Arg-D-Arg (SEQ ID NO: 186)   1 YIKVQKQDIVKLTVYDCISMIGLCA  (SEQ ID NO: 187)   2 IKVQKQDIVKLTVYDCISMIGLCA  (SEQ ID NO: 188)   3 KVQKQDIVKLTVYDCISMIGLCA  (SEQ ID NO: 189)   4 VQKQDIVKLTVYDCISMIGLCA (SEQ ID NO: 190)   5 QKQDIVKLTVYDCISMIGLCA (SEQ ID NO: 191)   6 KQDIVKLTVYDCISMIGLCA (SEQ ID NO: 192)   7 QDIVKLTVYDCISMTGLCA (SEQ ID NO: 193)   8 DTVKLTVYDCISMTGLCA (SEQ ID NO: 194)   9 IVKLTVYDCISMIGLCA (SEQ ID NO: 195)  10 VKLTVYDCISMIGLCA (SEQ ID NO: 196)  11 KLTVYDCISMIGLCA (SEQ ID NO: 197)  12 LTVYDCISMIGLCA (SEQ ID NO: 198)  13 TVYDCISMIGLCA (SEQ ID NO: 199)  14 VYDCISMIGLCA (SEQ TD NO: 200)  15 YDCISMIGLCA (SEQ ID NO: 201)  16 DCISMIGLCA (SEQ ID NO: 202)  17 CISMIGLCA (SEQ ID NO: 203)  18 ISMIGLCA (SEQ ID NO: 204)  19 SMIGLCA (SEQ ID NO: 205)  20 MIGLCA (SEQ ID NO: 206)  21 IGLCA (SEQ ID NO: 207)  22 YIKVQKQDIVKLTVYDCISMIGLC  (SEQ ID NO: 208)  23 YIKVQKQDIVKLTVYDCISMIGL  (SEQ ID NO: 209)  24 YIKVQKQDIVKLTVYDCISMIG (SEQ ID NO: 210)  25 YIKVQKQDIVKLTVYDCISMI (SEQ ID NO: 211)  26 YIKVQKQDIVKLTVYDCISM (SEQ ID NO: 212)  27 YIKVQKQDIVKLTVYDCIS (SEQ ID NO: 213)  28 YIKVQKQDIVKLTVYDCI (SEQ ID NO: 214)  29 YIKVQKQDIVKLTVYDC (SEQ ID NO: 215)  30 YIKVQKQDIVKLTVYD (SEQ ID NO: 216)  31 YIKVQKQDIVKLTVY (SEQ ID NO: 217)  32 YIKVQKQDIVKLTV (SEQ ID NO: 218)  33 YIKVQKQDIVKLT (SEQ ID NO: 219)  34 YIKVQKQDIVKL (SEQ ID NO: 220)  35 YIKVQKQDIVK (SEQ ID NO: 221)  36 YIKVQKQDIV (SEQ ID NO: 222)  37 YIKVQKQDI (SEQ ID NO: 223)  38 YIKVQKQD (SEQ ID NO: 224)  39 YIKVQKQ (SEQ ID NO: 225)  40 YIKVQK (SEQ ID NO: 226)  41 YIKVQ (SEQ ID NO: 227)  42(S1) EMFTILEEYFMYRGLLGLRIKYGRLFNEI  (SEQ ID NO: 228)  43(S2) MFTILEEYFMYRGLLGLRIKYGRLFNEI  (SEQ ID NO: 229)  44(S3) FTILEEYFMYRGLLGLRIKYGRLFNEI  (SEQ ID NO: 230)  45 TILEEYFMYRGLLGLRIKYGRLFNEI  (SEQ ID NO: 231)  46 ILEEYFMYRGLLGLRIKYGRLFNEI  (SEQ ID NO: 232)  47 LEEYFMYRGLLGLRIKYGRLFNEI  (SEQ ID NO: 233)  48 EEYFMYRGLLGLRIKYGRLFNEI (SEQ ID NO: 234)  49 EYFMYRGLLGLRIKYGRLFNEI (SEQ ID NO: 235)  50 YFMYRGLLGLRIKYGRLFNEI (SEQ ID NO: 236)  51 FMYRGLLGLRIKYGRLFNEI (SEQ ID NO: 237)  52 MYRGLLGLRIKYGRLFNEI (SEQ ID NO: 238)  53 YRGLLGLRIKYGRLFNEI (SEQ ID NO: 239)  54 RGLLGLRIKYGRLFNEI (SEQ ID NO: 240)  55 GLLGLRIKYGRLFNEI (SEQ ID NO: 241)  56 LLGLRIKYGRLFNEI (SEQ ID NO: 242)  57 LGLRIKYGRLFNEI (SEQ ID NO: 243)  58 GLRIKYGRLFNEI (SEQ ID NO: 244)  59 LRIKYGRLFNEI (SEQ ID NO: 245)  60 RIKYGRLFNEI (SEQ ID NO: 246)  61 IKYGRLFNEI (SEQ ID NO: 247)  62 KYGRLFNEI (SEQ ID NO: 248)  63 YGRLFNEI (SEQ ID NO: 249)  64 GRLFNEI (SEQ ID NO: 250)  65 RLFNEI (SEQ ID NO: 251)  66 LFNEI (SEQ ID NO: 252)  67 EMFTILEEYFMYRGLLGLRIKYGRLFNE  (SEQ ID NO: 253)  68(S4) EMFTILEEYFMYRGLLGLRIKYGRLFN  (SEQ ID NO: 254)  69(S5) EMFTILEEYFMYRGLLGLRIKYGRLF  (SEQ ID NO: 255)  70(S6) EMFTILEEYFMYRGLLGLRIKYGRL  (SEQ ID NO: 256)  71(S7) EMFTILEEYFMYRGLLGLRIKYGR  (SEQ ID NO: 257)  72(S8) EMFTILEEYFMYRGLLGLRIKYG (SEQ ID NO: 258)  73(S9) EMFTILEEYFMYRGLLGLRIKY (SEQ ID NO: 259)  74(S10)  EMFTILEEYFMYRGLLGLRIK (SEQ ID NO: 260)  75(S11)  EMFTILEEYFMYRGLLGLRI (SEQ ID NO: 261)  76(S12)  EMFTILEEYFMYRGLLGLR (SEQ ID NO: 262)  77(S13)  EMFTILEEYFMYRGLLGL (SEQ ID NO: 263)  78 EMFTILEEYFMYRGLLG (SEQ ID NO: 264)  79(S14)  EMFTILEEYFMYRGLL (SEQ ID NO: 265)  80(S15)  EMFTILEEYFMYRGL (SEQ ID NO: 266)  81(S16)  EMFTILEEYFMYRG (SEQ ID NO: 267)  82 EMFTILEEYFMYR (SEQ ID NO: 268)  83(S17)  EMFTILEEYFMY (SEQ ID NO: 269)  84 EMFTILEEYFM (SEQ ID NO: 270)  85 EMFTILEEYF (SEQ ID NO: 271)  86 EMFTILEEY (SEQ ID NO: 272)  87 EMFTILEE (SEQ ID NO: 273)  88 EMFTILE (SEQ ID NO: 274)  89 EMFTIL (SEQ ID NO: 275)  90 EMFTI (SEQ ID NO: 276)  91 MFTILLEEYFMYRGLL (SEQ ID NO: 277)  92 FTILLEEYFMYRGLL (SEQ ID NO: 278)  93 TILLEEYFMYRGLL (SEQ ID NO: 279)  94 ILLEEYFMYRGLL (SEQ ID NO: 280)  95 LLEEYFMYRGLL (SEQ ID NO: 281)  96 LEEYFMYRGLL (SEQ ID NO: 282)  97 EYFMYRGLL (SEQ ID NO: 283)  98 YFMYRGLL (SEQ ID NO: 284)  99 FMYRGLL (SEQ ID NO: 285) 100 MYRGLL (SEQ ID NO: 286) 101 YRGLL (SEQ ID NO: 287) 102(S18) MFTILEEYFMYRGLLGLRI (SEQ ID NO: 288) 103(S19) FTILLEEYFMYRGLLGLRI (SEQ ID NO: 289) 104(S20) TILLEEYFMYRGLLGLRI (SEQ ID NO: 290) 105(S21) ILLEEYFMYRGLLGLRI (SEQ ID NO: 291) 106(S22) LLEEYFMYGLLGLRI (SEQ ID NO: 292) 107 EYFMYRGLLGLRIKYG (SEQ ID NO: 293) 108 YFMYRGLLGLRIKYG (SEQ ID NO: 294) 109 FMYRGLLGLRIKYG (SEQ ID NO: 295) 110 MYRGLLGLRIKYG (SEQ ID NO: 296) 111 YRGLLGLRIKYG (SEQ ID NO: 297) 112 RGLLGLRIKYG (SEQ ID NO: 298) 113 GLLGLRIKYG (SEQ ID NO: 299) 114 LLGLRIKYG (SEQ ID NO: 300) 115 LGLRIKYG (SEQ ID NO: 301) 116 GLRIKYG (SEQ ID NO: 302) 117 LRIKYG (SEQ ID NO: 303) 118 RIKYG (SEQ ID NO: 304) 119 EEYFM (SEQ ID NO: 305) 120 EEYFMY (SEQ ID NO: 306) 121 EEYFMYR (SEQ ID NO: 307) 122 EEYFMYRG (SEQ ID NO: 308) 123 EEYFMYRGL (SEQ ID NO: 309) 124 EEYFMYRGLL (SEQ ID NO: 310) 125 EEYFMYRGLLG (SEQ ID NO: 311) 126 EEYFMYRGLLGL (SEQ ID NO: 312) 127 EEYFMYRGLLGLR (SEQ ID NO: 313) 128 EEYFMYRGLLGLRI (SEQ ID NO: 314) 129 EEYFMYRGLLGLRIK (SEQ ID NO: 315) 130 EEYFMYRGLLGLRIKY (SEQ ID NO: 316) T1 IVKLTVYDCI (SEQ ID NO: 317) T2 DIVKLTVYDC (SEQ ID NO: 318) T3 AIVKLTVYDCI (SEQ ID NO: 319) T4 DAVKLTVYDCI (SEQ ID NO: 320) T5 DIAKLTVYDCI (SEQ ID NO: 321) T6 DIVALTVYDCI (SEQ ID NO: 322) T7 DIVKATVYDCI (SEQ ID NO: 323) T8 DIVKLAVYDCI (SEQ ID NO: 324) T9 DIVKLTAYDCI (SEQ ID NO: 325) T10 DIVKLTVADCI (SEQ ID NO: 326) T11 DIVKLTVYACI (SEQ ID NO: 327) T12 DIVKLTVYDAI (SEQ ID NO: 328) T13 DIVKLTVYDCA (SEQ ID NO: 329) T14 EIVKLTVYDCI (SEQ ID NO: 330) T15 DIVKLTVYECI (SEQ ID NO: 331) T16 DIVRLTVYDCI (SEQ ID NO: 332) T17 DIVHLTVYDCI (SEQ ID NO: 333) T18 KIVKLTVYKCI (SEQ ID NO: 334) T19 DIVELTVYDCI (SEQ ID NO: 335) T20 DIVKLSVYDCI (SEQ ID NO: 336) T21 DIVKLYVYDCI (SEQ ID NO: 337) T22 DIVKLTVSDCI (SEQ ID NO: 338) T23 DIVKLTVTDCI (SEQ ID NO: 339) T24 DIVKLTVWDCI (SEQ ID NO: 340) T25 DIVKLTVFDCI (SEQ ID NO: 341) T26 DIVKLTVYDMI (SEQ ID NO: 342) T27 DIVKLTVYDSI (SEQ ID NO: 343) T28 DIVKLTVYDXaaI (SEQ ID NO: 344) T29 DIVKLTVYDXaaI (SEQ ID NO: 345) T30 DIVKLTVYDXaaI (SEQ ID NO: 346) T31 DIVKLTVYDXaaI (SEQ ID NO: 347) T32 DIVKLTVYDXaaI (SEQ ID NO: 348) T33 DLVKLTVYDCI (SEQ ID NO: 349) T34 DVVKLTVYDCI (SEQ ID NO: 350) T35 DILKLTVYDCI (SEQ ID NO: 351) T36 DIIKLTVYDCI (SEQ ID NO: 352) T37 DIVKVTVYDCI (SEQ ID NO: 353) T38 DIVKITVYDCI (SEQ ID NO: 354) T39 DIVKLTLYDCI (SEQ ID NO: 355) T40 DIVKLTIYDCI (SEQ ID NO: 356) T41 DIVKLTVYDCL (SEQ ID NO: 357) T42 DIVKLTVYDCV (SEQ ID NO: 358) T43 DIDKLTEYDSI (SEQ ID NO: 359) T44 DIPKLGVPDCI (SEQ ID NO: 360) T45 ICDYVTLKVID (SEQ ID NO: 361) T46 VDLVIDCIYKT (SEQ ID NO: 362) T47 DIVKLTVYDCIDIVKLTVYDCI (SEQ ID NO: 363) T48 IVKLTVYDCI (N-succinyl) (SEQ ID NO: 364) T49 DIVKLTVYDCIG (SEQ ID NO: 365) T50 DIVKLTVYDCI (N-acetyl) (SEQ ID NO: 366) T51 AIVKLTVYACI (SEQ ID NO: 367) T52 AIIKVYVYACI (SEQ ID NO: 368) P13 DIVKLTVYDCI (SEQ ID NO: 369) P13-R⁹ DIVKLTVYDCIRRRRRRRRR (SEQ ID NO: 378) P7 EEYFMYRGLLGLRIKYG (SEQ ID NO: 379) P7-R⁹  EEYFMYRGLLGLRIKYGRRRRRRRRR  (SEQ ID NO: 380) Z-1 LEEYFMYRGLLGLRIRRRRRRRRR  (SEQ ID NO: 381) Z-2 MFTILEEYFMYRGLLRRRRRRRRR  (SEQ ID NO: 382) Z-3 FTILEEYFMYRGLLRRRRRRRRR (SEQ ID NO: 383) Z-4 TILEEYFMYRGLLRRRRRRRRR (SEQ ID NO: 384) Z-5 ILEEYFMYRGLLRRRRRRRRR (SEQ ID NO: 385) Z-6 FTILEEYFMYRGLLGLRI (SEQ ID NO: 386) Z-7 TILEEYFMYRGLLGLRI (SEQ ID NO: 387) Z-8 ILEEYFMYRGLLGLRI (SEQ ID NO: 388) Z-9 LEEYFMYRGLLGLRI (SEQ ID NO: 389) Z-10 MFTILEEYFMYRGLL (SEQ ID NO: 390) Z-11 FTILEEYFMYRGLL (SEQ ID NO: 391) Z-12 TILEEYFMYRGLL (SEQ ID NO: 392) Z-13 ILEEYFMYRGLL (SEQ ID NO: 393) Z-14 FTILEEYFMYRGLLGLRIRRRRRRRRR  (SEQ ID NO: 394) Z-15 TILEEYFMYRGLLGLRIRRRRRRRRR  (SEQ ID NO: 395) Z-16 ILEEYFMYRGLLGLRIRRRRRRRRR  (SEQ ID NO: 396) Legend to Table 1: Xaa in peptide T28 (SEQ ID NO: 344) and T28-R⁹ (SEQ ID NO: 158) is L-Cysteine(S-carboxymethyl); Xaa in peptide T29 (SEQ ID NO: 345) and T29-R⁹ (SEQ ID NO: 159) is L-Cysteine(S-carbamidomethyl); Xaa in peptide T30 (SEQ ID NO: 346) and T30-R⁹ (SEQ ID NO: 160) is L-Cysteine(S-Acm); Xaa in peptide T31 (SEQ ID NO: 347) and T31-R⁹ (SEQ ID NO: 161) is α-Aminobutyric acid; and Xaa in peptide T32 (SEQ ID NO: 348) and T32-R⁹ (SEQ ID NO: 162) is L-Norvaline.

Peptides of the invention and compositions comprising the same are effective to modulate cellular activity. In some embodiments, modulating cellular activity is accomplished by modulating cellular signaling. Activities can be regulated, for example, by a toll-like receptor. In some embodiments, peptides and compositions of the invention inhibit cytokine secretion. In some embodiments, peptides and compositions of the invention enhance cytokine secretion. In some embodiments, cytokine secretion is in response to toll-like receptor-dependent stimulation.

In some embodiments, administration of a peptide derived from A52R or P13 (SEQ ID NO: 369) can inhibit cytokine secretion by at least 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80% or 90%. In some embodiments, administration of a peptide derived from A52R or P13 (SEQ ID NO: 369) can enhance cytokine secretion by 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80% or 90%. In some embodiments the cytokine secretion is a result of TLR-dependent signaling.

In some embodiments, the activity mediated by a toll-like receptor is TNF-α secretion. Peptides and compositions of the invention are effective to provide 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80% or 90% inhibition of TNF-α secretion following stimulation by LPS. Peptides and compositions of the invention are effective to provide 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80% or 90% inhibition of TNF-α secretion following stimulation by CpG-ODN. Peptides and compositions of the invention are effective to provide 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80% or 90% inhibition of TNF-α secretion following stimulation by LPS and/or CpG-ODN. Peptides and compositions of the invention are effective to provide 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80% or 90% enhancement of TNF-α secretion following stimulation by LPS. Peptides and compositions of the invention are effective to provide 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80% or 90% enhancement of TNF-α secretion following stimulation by CpG-ODN. Peptides and compositions of the invention are effective to provide 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80% or 90% enhancement of TNF-α secretion following stimulation by LPS and/or CpG-ODN.

Some embodiments of the invention contemplate a peptide comprising the amino acid sequence DIVKLTVYDCI (SEQ ID NO: 369), linked to a 9-arginine cell transduction sequence or other type of cell transduction sequence. The peptide DIVKLTVYDCIRRRRRRRRR (SEQ ID NO: 378) effectively inhibited cytokine secretion in response to TLR activation. The peptide had no effect on cytokine secretion resulting from cell activation that was initiated independent of TLR stimulation. Employing a mouse model of otitis media with effusion (OME), administration of heat-inactivated Streptococcus pneumoniae (S. pneumoniae) into the middle ears of BALB/c mice resulted in a significant inflammatory response that was dramatically reduced with peptide treatment. Experiments have also demonstrated that the peptide will reduce pro-inflammatory mediators in a mouse model of LPS-induced septic shock. The peptide is effective in the treatment of chronic inflammation initiated by bacterial or viral infections.

In some embodiments, the invention contemplates a pharmaceutical composition effective to:

a) decrease the amount of an middle ear fluid by about 30-80%;

b) decrease infiltrating cell number in middle ear fluid by about 30-80%; and

c) decrease the thickness of a tympanic membrane by about 30-80% in a mouse comprising inflammation of the ear, wherein the composition is administered to the mouse in an amount of about 0.1 μg to 60 μg. In some embodiments, the pharmaceutical composition is an aural pharmaceutical composition. In some embodiments, the pharmaceutical composition is formulated for intra-aural administration. In some embodiments, the pharmaceutical composition is formulated as a drop. In some embodiments, the pharmaceutical composition is formulated as an ear drop.

In some embodiments, a pharmaceutical composition of the invention comprises a peptide. In some embodiments, the peptide is P13 (SEQ ID NO: 369) or a variant, derivative, stereoisomer, or analogue thereof. In some embodiments, the peptide is P13 (SEQ ID NO: 369), a peptide comprising P13 (SEQ ID NO: 369) and a poly-argenine domain, or a peptide of Table 1. In some embodiments, the peptide is P13 (SEQ ID NO: 369). In some embodiments, the peptide is derived from A52R. In some embodiments, the peptide is a peptide of S1-S22 (SEQ ID NOs: 228-230; 254-263; 265-267; 269; and 288-292). The invention also contemplates a method of treating ear inflammation in an animal in need or want thereof, the method comprising administering to the animal a pharmaceutical composition of the invention. The ear inflammation can be associated with noise-induced hearing loss, or age-related hearing loss.

The in vivo effectiveness of P13 (SEQ ID NO: 369) was demonstrated using a mouse model of otitis media (OM). OM is an inflammatory disease of the middle ear accompanied by fluid accumulation. It is characterized by an infiltration of leukocytes, macrophages, and mast cells and a release of inflammatory mediators and enzymes (Reference 21). These mediators increase vascular permeability and secretory activity, and initiate a cascade of inflammatory events, resulting in fluid accumulation and mucin secretion (References 26 and 27). The initiation of inflammation in OM has been attributed to a variety of factors, including bacterial or viral infections, Eustachian tube dysfunction, and allergy. However, the evidence points to a bacterial etiology leading to cytokine activation in the majority of cases. Bacteria have been cultured from up to 40% of effusions and studies have shown bacterial DNA by PCR in approximately 80% of effusions, often in the absence of viable organisms in culture (Reference 28). The most common bacteria invading the middle ear are S. pneumoniae, H. influenzae, and M. catarralis. These three bacteria account for 85% of acute middle ear infections (Reference 27), with S. pneumoniae being the most frequent cause. Initially, live bacteria trigger acute inflammation, which is designed to eliminate the pathogen. During acute infection, interference with the innate immune response would be potentially harmful to the host and can lead to further bacterial spread. Acute inflammation initiated by bacterial infections self-resolves or is treatable by antibiotics. Chronic inflammation involves continued activation of the immune system, often by non-viable bacterial products. OM is often prolonged or anti-biotic resistant, suggesting TLR stimulation in the absence of live bacteria.

Treatment of mice with P13 (SEQ ID NO: 369) in the experiments disclosed herein resulted in a significant reduction in bacterial-induced inflammation in the middle ear. Fluid accumulation, infiltrating cells, and tympanic membrane thickness in the middle ear were all dramatically reduced with peptide treatment. Administration of heat-inactivated bacteria, which have a number of potential TLR ligands, induced an inflammatory response in the middle ear most likely resulting from activation of multiple TLRs. The use of heat-inactivated bacteria allowed for an examination of peptide inhibition of inflammation without the potential for the bacterial spread that can occur in an acute infection initiated with live bacteria. The ability of peptide P13 (SEQ ID NO: 369) to inhibit this response significantly in vivo is consistent with the in vitro data showing inhibition of cytokine secretion in response to multiple TLR ligands used either individually or in combination. In these studies, a single dose of peptide was administered at the same time as heat-inactivated S. pneumoniae into the middle ears of normal BALB/c mice. The in vitro data also showed inhibition of cytokine secretion even when peptide P13 (SEQ ID NO: 369) was added several hours after initiation of TLR activation.

In addition to P13 (SEQ ID NO: 369) and the peptides of Table 1, the invention disclosed herein also contemplates peptides more broadly characterized as variants, derivatives, stereoisomers, or analogues of any peptide of the instant invention. These terms are not exclusive, and can be contemplated in concert to describe peptides that are described by one or more of the terms. Many such peptides, not all of which are expressly disclosed herein, are contemplated as peptides, as components of a formulation or pharmaceutical composition, and as elements of the methods and uses of the instant invention.

In some embodiments, the variant, derivative, stereoisomer, or analogue of a peptide of the invention comprises a peptide comprising a peptide of the invention and a poly-argenine sequence. In some embodiments, the variant, derivative, stereoisomer, or analogue of a peptide of the invention comprises one or more D-amino acid residues. In some embodiments, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, or 50 of the amino acid residues of the variant, derivative, stereoisomer, or analogue of a peptide of the invention possess the D-configuration. In some embodiments, all the amino acid residues of the variant, derivative, stereoisomer, or analogue of a peptide of the invention possess the D-configuration.

In some embodiments, the variant, derivative, stereoisomer, or analogue of a peptide of the invention comprises one or more D-amino acid residues in the region of the peptide analogous to or derived from a peptide of the invention. In some embodiments, the region of the peptide analogous to or derived from P13 (SEQ ID NO: 369) comprises more than one D-amino acid residue.

In some embodiments, the region of the peptide analogous to or derived from a peptide of the invention comprises a D-amino acid residue. In some embodiments, the poly-argenine sequence comprises a D-amino acid residue. In some embodiments, the poly-argenine sequence comprises more than one D-amino acid residue. In some embodiments, either the region of the peptide analogous to or derived from a peptide of the invention or the poly-argenine sequence comprises a D-amino acid residue. In some embodiments, either the region of the peptide analogous to or derived from a peptide of the invention or the poly-argenine sequence comprises more than one D-amino acid residue. In some embodiments, both the region of the peptide analogous to or derived from a peptide of the invention and the poly-argenine sequence independently comprise a D-amino acid residue. In some embodiments, both the region of the peptide analogous to or derived from a peptide of the invention and the poly-argenine sequence independently comprise more than one D-amino acid residue.

In some embodiments comprising a peptide comprising a variant, derivative, stereoisomer, or analogue of a peptide of the invention comprising a poly-argenine sequence, the region of the peptide analogous to or derived from P13 (SEQ ID NO: 369) consists of D-amino acid residues. In some embodiments, the region of the peptide analogous to or derived from a peptide of the invention consists of D-amino acid residues, and the poly-argenine sequence consists of L-amino acid residues. In some embodiments, the region of the peptide analogous to or derived from a peptide of the invention consists of D-amino acid residues, and the poly-argenine sequence comprises one or more D-amino acid residues.

In some embodiments, the poly-argenine sequence consists of D-amino acid residues. In some embodiments, the poly-argenine sequence consists of D-amino acid residues, and the region of the peptide analogous to or derived from a peptide of the invention consists of L-amino acid residues. In some embodiments, the poly-argenine sequence consists of D-amino acid residues, and the region of the peptide analogous to or derived from a peptide of the invention comprises one or more D-amino acid residues.

In some embodiments comprising a peptide comprising a variant, derivative, stereoisomer, or analogue of a peptide of the invention comprising a poly-argenine sequence, the peptide consists of D-amino acid residues.

In some embodiments, a peptide comprises an amino acid residue comprising a stereogenic side chain, for example, threonine, allo-threonine, isoleucine, or allo-isoleucine. In some embodiments, a peptide comprises a D-allo-threonine, or D-alto-isoleucine residue.

Diseases

The initiation of an inflammatory response to pathogens is a component of the innate immune response and is designed to control infection. However, the sustained production of inflammatory mediators can lead to chronic inflammation, tissue damage and disease development. The signaling cascade initiated by PAMP/TLR interactions and culminating in cell activation has been associated with many disease states, including otitis media, inner ear inflammation, sepsis, autoimmune diseases, asthma, heart disease and cancer (Reference 29). OM is an inflammatory disease of the middle ear. OM is often prolonged or antibiotic resistant; these characteristics suggest TLR stimulation in the absence of live bacteria. An abnormal TLR signaling response could lead to exaggerated cell-activation responses contributing to sepsis (Reference 30 and 31).

Inflammation is also an aspect of autoimmunity, and is hypothesized to play a role in tissue destruction in diseases such as multiple sclerosis, rheumatoid arthritis and insulin-dependent diabetes mellitus (Reference 32). Cells of the innate immune system have an essential role in acquired/adaptive immunity. TLR proteins are involved in the maturation and activation of dendritic cells, the antigen-presenting cell type considered most relevant to development of acquired immunity (Reference 33). Allergic asthma is an example of a chronic inflammatory disease with an adaptive immune response, and the TLR signaling pathway is implicated in the induction phase of an allergic phenotype (Reference 30). Bacterial and viral infections, causing increased inflammatory cell activation, are the main cause of exacerbations in diseases such as asthma and COPD (chronic obstructive pulmonary disease) (Reference 30).

In some embodiments, the inflammation is caused by a virus, bacteria, fungi, antigen, self-antigen, or a combination thereof. In some embodiments, the inflammation is associated with a virus, bacteria, fungi, antigen, self-antigen, or a combination thereof. In some embodiments, the inflammation is correlated with a virus, bacteria, fungi, antigen, self-antigen, or a combination thereof. In some embodiments, the inflammation is accompanied by a virus, bacteria, fungi, antigen, self-antigen, or a combination thereof. In some embodiments, an organism having the inflammation also has a virus, bacteria, fungi, antigen, self-antigen, or a combination thereof.

In some embodiments, the inflammation is caused by noise or noise-induced damage. The damage can arise from an isolated incident of damaging noise exposure, or from long-term habitual noise exposure. Non-limiting examples of noise attributes that can cause or exacerbate ear inflammation and hearing loss include volume, intensity, frequency, and duration. Noise exposure can worsen a pre-existing hearing problem, or can cause hearing loss in an animal that previously enjoyed ordinary hearing capacity. The hearing loss can be a general lack of sensitivity to sound, or can be limited to specific sounds, frequencies or stimuli.

In some embodiments, the inflammation is caused by age or age-related damage. The damage can arise from the natural aging process, or from a health condition that promotes tissue degradation analogous to that of the aging process. Aging can worsen a pre-existing hearing problem, or can cause hearing loss in an animal that previously enjoyed ordinary hearing capacity. Age-related hearing loss also contemplates the tendency of an animal, advanced in age, to be more susceptible to damage from external stimuli than an analogous, younger animal. The hearing loss can be a general lack of sensitivity to sound, or can be limited to specific sounds, frequencies or stimuli.

In some embodiments, a subject's ear or hearing has not been damaged and/or is not inflamed. Such a subject experiences normal hearing. Administration of a peptide of the invention or a composition thereof can improve the subject's ordinary hearing as described herein.

In some embodiments, the peptides provided herein are administered to a subject for the treatment of inflammation. Non-limiting examples of the causes of inflammation include viral, bacterial or fungal infection, noise, and age. In some embodiments, the inflammation is a result of a response to a self-antigen or any other antigen. In some embodiments, the inflammation is a result of a response to an anti-self-antigen. In some embodiments, the inflammation is a result of a response to external stimuli, such as sound.

In some embodiments, the inflammation comprises inflammation of the ear. The inflammation of the ear can be inflammation of the inner ear and/or middle ear. In some embodiments, the inflammation comprises otitis media. In some embodiments, pharmaceutical compositions of the instant invention are used for the treatment of otitis media.

C3H/HeJ mice, defective in TLR4 signaling, are known to develop chronic otitis media (“COM”) spontaneously. Such mice with inner ear inflammation may show sensorineural hearing loss in addition to middle ear conductive hearing loss. Histologic examination of the middle and inner ear of C3H/HeJ mice with COM has documented a thickening of the mucosal surfaces of the middle ear, thickening of the round window membrane, fibrosis, labyrinthitis, and Eustachian tube obstruction. These histologic changes correlate with the histology seen with human temporal bone from patients with a history of COM and labyrinthitis. The mouse studies have shown that C3H/HeJ mice with COM have gram-negative Klebsiella bacteria in the middle ear. The analogies between the observations in the mouse experiments and those in human COM and labrinthitis patients suggest that mouse experiments with a peptide or pharmaceutical composition of the invention disclosed herein provide results predictive of what the therapeutic effect would be in a human subject.

In some embodiments, otitis media is associated with hearing loss or reduced hearing. Administration of a peptide of the invention of a pharmaceutical composition thereof can improve the hearing of the affected organism back to ordinary hearing levels. In some embodiments, administration of a therapeutically-effective amount of a pharmaceutical composition to an organism in need or want thereof improves the hearing of the organism, wherein the organism has both otitis media and lessened hearing. In some embodiments, the peptide or pharmaceutical composition is administered topically. In some embodiments, upon administration of a peptide of the invention of a pharmaceutical composition thereof, an organism with hearing loss recovers hearing faster than hearing would be recovered without administration of the peptide or pharmaceutical composition.

In some embodiments, administration of a therapeutically-effective amount of a peptide of the invention or a pharmaceutical composition comprising the same to an organism with otitis media, wherein the organism is in need or want thereof, provides therapeutic relief of a symptom of otitis media. Non-limiting examples of the symptoms of otitis media include otalgia (pain), otorrhea, fever, irritability, anorexia, vomiting, hearing loss, or diarrhea. In some embodiments, the symptom is pain. In some embodiments, the symptom is hearing loss.

In some embodiments, the inflammation comprises inflammation of the skin, joints, muscular tissue, brain, or connective tissue. In some embodiments, pharmaceutical compositions of the instant invention are used for the treatment of inflammation of the skin, joints, muscular tissue, brain, or connective tissue.

In some embodiments, the inflammation comprises arthritis, dermatitis, Lupus erythematosus, meningitis, or psoriasis. In some embodiments, the arthritis comprises osteoarthritis, rheumatoid arthritis, septic arthritis, gout, pseudo-gout, juvenile idiopathic arthritis, Still's disease, or ankylosing spondylitis. In some embodiments, the dermatitis comprises spongiotic dermatitis, childhood eczema, allergic contact dermatitis, seborrhoeic dermatitis, dyshidrotic dermatitis, urticaria, vesicular or bullous dermatitis, or papular urticaria. In some embodiments, the psoriasis comprises plaque psoriasis, flexural psoriasis, guttate psoriasis, pustular psoriasis, nail psoriasis, psoriatic arthritis, or erythrodermic psoriasis.

In some embodiments, the administration comprises topical application. In some embodiments, the administration comprises topical application to the skin, hair, outer ear, tympanic membrane, nasal cavity, buccal cavity, or sublingual cavity.

In some embodiments, the peptides of the invention and pharmaceutical composition comprising the same are effective for the treatment of sinusitis. In some embodiments, administration of a pharmaceutical composition of the invention to an organism in need or want thereof provides a therapeutic effect on sinusitis or a symptom thereof. Non-limiting examples of symptoms of sinusitis include stuffy or runny nose, nasal discharge, bloody nasal discharge, sneezing, coughing, nasal pain, headache, postnasal drip, itchy face, diminished scent or taste senses, bad breath, fever, chill, dental pain, or face pain. In some embodiments, a pharmaceutical composition of the invention is administered as an aerosol, vapor, spray, or mist.

Therapeutic Uses

Each of U.S. patent application Ser. No. 12/794,185 (now U.S. Publication No. US20100317564) and International Patent Application No. PCT/US2010/037443 (now International Publication No. WO2010141845) is incorporated by reference in its entirety for the teachings of peptides having anti-inflammatory and related therapeutic effects.

A, “patient,” “subject,” or “host,” to be treated with a pharmaceutical composition of the present invention may mean either a human or non-human animal. In some embodiments, the subject is human. The peptides of the present invention are useful in the treatment of such diseases and disorders such as but not limited to those involving inflammation and hearing loss. In one embodiment, the peptides and pharmaceutical compositions of the present invention may be used in the manufacture of a medicament for any number of uses, including, for example, treating any disease or other treatable condition of a patient.

A, “therapeutic effect,” as the term is used herein, encompasses a therapeutic benefit and/or a prophylactic benefit. By therapeutic benefit is meant eradication or amelioration of the underlying disorder being treated. Also, a therapeutic benefit is achieved with the eradication or amelioration of one or more of the physiological symptoms associated with the underlying disorder such that an improvement is observed in the patient, notwithstanding that the patient may still be afflicted with the underlying disorder. For prophylactic benefit, the compositions may be administered to a patient at risk of developing a particular disease, or to a patient reporting one or more of the physiological symptoms of a disease, even though a diagnosis of this disease may not have been made. A prophylactic effect includes delaying or eliminating the appearance of a disease or condition, delaying or eliminating the onset of symptoms of a disease or condition, slowing, halting, or reversing the progression of a disease or condition, or any combination thereof.

Tissue damage resulting from noise-induced trauma can initiate toll-like receptor signaling, which causes inflammation that exacerbates hearing loss. The peptides described herein are suitable to inhibit the signaling, thereby inhibiting secretion of TNF-α, and providing a therapeutic effect to a subject suffering from noise-induced hearing loss.

Necrotic cell death is associated with the release of danger signals, which can stimulate the immune system through toll-like receptors. This stimulation can lead to inflammation, which can cause or aggravate hearing loss. Necrotic cell death occurs in animals during the natural aging process, and provides a pathway for age-related hearing loss. The peptides described herein are suitable to inhibit the stimulation, thereby inhibiting secretion of TNF-α, and providing a therapeutic effect to a subject suffering from age-related hearing loss.

The invention also contemplates improvement of normal hearing in a subject using any peptide disclosed herein. Normal hearing is auditory function that has not been damaged or degraded. Administration of a peptide of the invention to a subject in need or want of improved normal hearing can result in the improvement of hearing as described herein.

In some embodiments, the invention provides a method of treating noise-induced hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of Formula (I) or Formula (II) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (I). In some embodiments, the peptide is a peptide of Formula (II). In some embodiments, the peptide is a peptide of either Formula (I) or Formula (II).

In some embodiments, the peptide is a stereoisomer of Formula (I) or Formula (II). A stereoisomer of Formula (I) or Formula (II) can be any type of stereoisomer described herein, for example, a peptide possessing one or more D-amino acid residues. A D-amino acid residue can be present in any or all of tran^(N), pep^(N), X¹⁻¹¹, pep^(C), and tran^(C). Any number of amino acid residues can possess the D-configuration, up to, for example, every stereogenic amino acid residue in the peptide.

In some embodiments, x is 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10. In some embodiments, x is 1, 2, 3, 4, or 5. In some embodiments, x is 1, 2, or 3. In some embodiments, x is 1 or 2. In some embodiments, x is 1. In some embodiments, x is 2.

Non-limiting examples of acidic amino acid residues include residues of aspartic acid (D); glutamic acid (E); and any synthetic amino acid with a side chain possessing a carboxylic acid functional group. In some embodiments, an acidic amino acid residue is aspartic acid (D) or glutamic acid (E).

Non-limiting examples of basic amino acid residues include residues of lysine (K); arginine (R); histidine (H); and any synthetic amino acid with a side chain possessing a nitrogen atom that is capable of being protonated at physiological pH. In some embodiments, a basic amino acid residue is lysine (K); arginine (R); or histidine (H).

Non-limiting examples of aromatic amino acid residues include residues of phenylalanine (F); tryptophan (W); histidine (H); tyrosine (Y) and any synthetic amino acid with a side chain possessing an aromatic ring. In some embodiments, an aromatic amino acid residue is phenylalanine (F); tryptophan (W); histidine (H); or tyrosine (Y). In some embodiments, an aromatic amino acid residue is phenylalanine (F); tryptophan (W); or tyrosine (Y).

Pep^(N) and pep^(C) independently are peptide sequences or are absent. The peptide sequences can be natural, unnatural, or synthetic.

Tran^(N) and tran^(C) independently are transducing sequences as described herein or are absent.

Cap^(N) is a capping group at the N-terminus of a peptide. When two cap^(N) groups are attached to the same nitrogen, the two groups can be the same or different. Non-limiting examples of cap^(N) include H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, and an aminocarbonyl group. A cap^(N) group together with the nitrogen atom to which the cap^(N) group is bound can form, for example, an amide, a carbamate, a urethane, a heterocycle, or an amine Two cap^(N) groups bound to the same nitrogen atom can form together with the nitrogen atom a heterocycle.

Cap^(C) is a capping group at the C-terminus of a peptide. Non-limiting examples of cap^(C) groups include OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, and a heterocycle. A cap^(C) group together with the carbonyl to which the cap^(C) group is bound can form, for example, a carboxylic acid, an ester, or an amide.

In some embodiments, cap^(N) is H. In some embodiments, cap^(C) is OH. In some embodiments, cap^(N) is H and cap^(C) is OH.

Any side chain of any amino acid residue can be capped with a capping group. Non-limiting examples of side chain functional groups that can be capped include a hydroxyl group, a thiol group, a carboxylic acid, an amide, an amino group, an imidazole group, and a guanadino group. For examples of capping groups, see GREENE'S PROTECTIVE GROUPS IN ORGANIC SYNTHESIS, 4th Ed. (Wiley 2006) (1980) and PROTECTING GROUPS, 3d Ed. (Thieme 2005) (1994), each of which is incorporated by reference in its entirety.

Non-limiting examples of suitable capping groups for a hydroxyl group include alkyl, haloalkyl, aryl, aralkyl, and acyl groups.

Non-limiting examples of suitable capping groups for a thiol group include alkyl, haloalkyl, aryl, aralkyl, acyl, carboxyalkyl, carbamidoalkyl, and acetamidoalkyl groups.

Non-limiting examples of suitable capping groups for a carboxylic acid group include alkyl, haloalkyl, aryl, and aralkyl groups.

Non-limiting examples of suitable capping groups for an amino group include examples as disclosed herein for cap^(N).

Non-limiting examples of alkyl include straight, branched, and cyclic alkyl groups. Non-limiting examples of straight alkyl groups include methyl, ethyl, propyl, butyl, pentyl, hexyl, heptyl, octyl, nonyl, and decyl.

Branched alkyl groups include any straight alkyl group substituted with any number of alkyl groups. Non-limiting examples of branched alkyl groups include isopropyl, isobutyl, sec-butyl, and t-butyl.

Non-limiting examples of cyclic alkyl groups include cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptlyl, and cyclooctyl groups. Cyclic alkyl groups also include fused-, bridged-, and spiro-bicycles and higher fused-, bridged-, and spiro-systems. A cyclic alkyl group can be substituted with any number of straight or branched alkyl groups.

A halo-alkyl group can be any alkyl group substituted with any number of halogen atoms, for example, fluorine, chlorine, bromine, and iodine atoms.

An alkoxy group can be, for example, an oxygen atom substituted with any alkyl group.

An aryl group can be heterocyclic or non-heterocyclic. An aryl group can be monocyclic or polycyclic. An aryl group can be substituted with any number of alkyl groups and halogen atoms. Non-limiting examples of aryl groups include phenyl, toluyl, naphthyl, pyrrolyl, pyridyl, imidazolyl, thiophenyl, and furyl.

An aryloxy group can be, for example, an oxygen atom substituted with any aryl group, such as phenoxy.

An aralkyl group can be, for example, any alkyl group substituted with any aryl group, such as benzyl.

An arylalkoxy group can be, for example, an oxygen atom substituted with any aralkyl group, such as benzyloxy.

A heterocycle can be any ring containing a ring atom that is not carbon. A heterocycle can be substituted with any number of alkyl groups and halogen atoms. Non-limiting examples of heterocycles include pyrrole, pyrrolidine, pyridine, piperidine, succinamide, maleimide, morpholine, imidazole, thiophene, furan, tetrahydrofuran, pyran, and tetrahydropyran.

An acyl group can be, for example, a carbonyl group substituted with an alkyl, alkoxy, aryl, aryloxy, aralkyl, arylalkoxy, or a heterocycle. Non-limiting examples of acyl include acetyl, benzoyl, benzyloxycarbonyl, phenoxycarbonyl, methoxycarbonyl, and ethoxycarbonyl.

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; 363-369; and 378. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; and 363-368. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 177-186. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 317-361. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 363-369 and 378. In some embodiments, the peptide is SEQ ID NO: 369. In some embodiments, the peptide is SEQ ID NO: 378. In some embodiments, the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a method of treating noise-induced hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of Formula (III) or Formula (IV) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-tran^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (III),

(cap^(N))(cap^(N))N-tran^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (IV), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (III). In some embodiments, the peptide is a peptide of Formula (IV). In some embodiments, the peptide is a peptide of either Formula (III) or Formula (IV)

In some embodiments, the invention provides a method of treating noise-induced hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of Formula (V) or Formula (VI) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (V),

(cap^(N))(cap^(N))N-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (VI), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(C) is a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (V). In some embodiments, the peptide is a peptide of Formula (VI). In some embodiments, the peptide is a peptide of either Formula (V) or Formula (VI)

In some embodiments, the invention provides a method of treating noise-induced hearing loss, the method comprising administering a therapeutically-effective amount of a peptide to a subject in need or want thereof, wherein the peptide comprises: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing.

A stereoisomer can be any form of stereoisomer described herein.

The optional capping groups on the N-terminus, the C-terminus, and each amino acid residue side chain can be any suitable capping group described herein.

The peptide can further comprise a transducing sequence. The transducing sequence can be any transducing sequence described herein. The transducing sequence can be positioned at either the N- or the C-terminus of the peptide. In some embodiments, the transducing sequence is positioned at the C-terminus of the peptide. The transducing sequence can be any poly-arginine sequence described herein.

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; 379; 380; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 187-316. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 381-396. In some embodiments, the peptide is SEQ ID NO: 379. In some embodiments, the peptide is SEQ ID NO: 380. In some embodiments, the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a method of treating age-related hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of Formula (I) or Formula (II) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (I). In some embodiments, the peptide is a peptide of Formula (II). In some embodiments, the peptide is a peptide of either Formula (I) or Formula (II).

In some embodiments, the peptide is a stereoisomer of Formula (I) or Formula (II). A stereoisomer of Formula (I) or Formula (II) can be any type of stereoisomer described herein, for example, a peptide possessing one or more D-amino acid residues. A D-amino acid residue can be present in any or all of tran^(N), pep^(N), X¹⁻¹¹, pep^(C), and tran^(C). Any number of amino acid residues can possess the D-configuration, up to, for example, every stereogenic amino acid residue in the peptide.

In some embodiments, x is 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10. In some embodiments, x is 1, 2, 3, 4, or 5. In some embodiments, x is 1, 2, or 3. In some embodiments, x is 1 or 2. In some embodiments, x is 1. In some embodiments, x is 2.

Non-limiting examples of acidic amino acid residues include residues of aspartic acid (D); glutamic acid (E); and any synthetic amino acid with a side chain possessing a carboxylic acid functional group. In some embodiments, an acidic amino acid residue is aspartic acid (D) or glutamic acid (E).

Non-limiting examples of basic amino acid residues include residues of lysine (K); arginine (R); histidine (H); and any synthetic amino acid with a side chain possessing a nitrogen atom that is capable of being protonated at physiological pH. In some embodiments, a basic amino acid residue is lysine (K); arginine (R); or histidine (H).

Non-limiting examples of aromatic amino acid residues include residues of phenylalanine (F); tryptophan (W); histidine (H); tyrosine (Y) and any synthetic amino acid with a side chain possessing an aromatic ring. In some embodiments, an aromatic amino acid residue is phenylalanine (F); tryptophan (W); histidine (H); or tyrosine (Y). In some embodiments, an aromatic amino acid residue is phenylalanine (F); tryptophan (W); or tyrosine (Y).

Pep^(N) and pep^(C) independently are peptide sequences or are absent. The peptide sequences can be natural, unnatural, or synthetic.

Tran^(N) and tran^(C) independently are transducing sequences as described herein or are absent.

Cap^(N) is a capping group at the N-terminus of a peptide. When two cap^(N) groups are attached to the same nitrogen, the two groups can be the same or different. Non-limiting examples of cap^(N) include H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, and an aminocarbonyl group. A cap^(N) group together with the nitrogen atom to which the cap^(N) group is bound can form, for example, an amide, a carbamate, a urethane, a heterocycle, or an amine Two cap^(N) groups bound to the same nitrogen atom can form together with the nitrogen atom a heterocycle.

Cap^(C) is a capping group at the C-terminus of a peptide. Non-limiting examples of cap^(C) groups include OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, and a heterocycle. A cap^(C) group together with the carbonyl to which the cap^(C) group is bound can form, for example, a carboxylic acid, an ester, or an amide.

In some embodiments, cap^(N) is H. In some embodiments, cap^(C) is OH. In some embodiments, cap^(N) is H and cap^(C) is OH.

Any side chain of any amino acid residue can be capped with any suitable capping group described herein.

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; 363-369; and 378. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; and 363-368. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 177-186. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 317-361. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 363-369 and 378. In some embodiments, the peptide is SEQ ID NO: 369. In some embodiments, the peptide is SEQ ID NO: 378. In some embodiments, the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a method of treating age-related hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of Formula (III) or Formula (IV) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-tran^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (III),

(cap^(N))(cap^(N))N-tran^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (IV), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (III). In some embodiments, the peptide is a peptide of Formula (IV). In some embodiments, the peptide is a peptide of either Formula (III) or Formula (IV).

In some embodiments, the invention provides a method of treating age-related hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of Formula (V) or Formula (VI) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (V),

(cap^(N))(cap^(N))N-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (VI), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(C) is a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (V). In some embodiments, the peptide is a peptide of Formula (VI). In some embodiments, the peptide is a peptide of either Formula (V) or Formula (VI).

In some embodiments, the invention provides a method of treating age-related hearing loss, the method comprising administering a therapeutically-effective amount of a peptide to a subject in need or want thereof, wherein the peptide comprises: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing.

A stereoisomer can be any form of stereoisomer described herein.

The optional capping groups on the N-terminus, the C-terminus, and each amino acid residue side chain can be any suitable capping group described herein.

The peptide can further comprise a transducing sequence. The transducing sequence can be any transducing sequence described herein. The transducing sequence can be positioned at either the N- or the C-terminus of the peptide. In some embodiments, the transducing sequence is positioned at the C-terminus of the peptide. The transducing sequence can be any poly-arginine sequence described herein.

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; 379; 380; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 187-316. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 381-396. In some embodiments, the peptide is SEQ ID NO: 379. In some embodiments, the peptide is SEQ ID NO: 380. In some embodiments, the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a method of improving normal hearing, the method comprising administering a therapeutically-effective amount of a peptide of Formula (I) or Formula (II) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (I). In some embodiments, the peptide is a peptide of Formula (II). In some embodiments, the peptide is a peptide of either Formula (I) or Formula (II).

In some embodiments, the peptide is a stereoisomer of Formula (I) or Formula (II). A stereoisomer of Formula (I) or Formula (II) can be any type of stereoisomer described herein, for example, a peptide possessing one or more D-amino acid residues. A D-amino acid residue can be present in any or all of tran^(N), pep^(N), X¹⁻¹¹, pep^(C), and tran^(C). Any number of amino acid residues can possess the D-configuration, up to, for example, every stereogenic amino acid residue in the peptide.

In some embodiments, x is 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10. In some embodiments, x is 1, 2, 3, 4, or 5. In some embodiments, x is 1, 2, or 3. In some embodiments, x is 1 or 2. In some embodiments, x is 1. In some embodiments, x is 2.

Non-limiting examples of acidic amino acid residues include residues of aspartic acid (D); glutamic acid (E); and any synthetic amino acid with a side chain possessing a carboxylic acid functional group. In some embodiments, an acidic amino acid residue is aspartic acid (D) or glutamic acid (E).

Non-limiting examples of basic amino acid residues include residues of lysine (K); arginine (R); histidine (H); and any synthetic amino acid with a side chain possessing a nitrogen atom that is capable of being protonated at physiological pH. In some embodiments, a basic amino acid residue is lysine (K); arginine (R); or histidine (H).

Non-limiting examples of aromatic amino acid residues include residues of phenylalanine (F); tryptophan (W); histidine (H); tyrosine (Y) and any synthetic amino acid with a side chain possessing an aromatic ring. In some embodiments, an aromatic amino acid residue is phenylalanine (F); tryptophan (W); histidine (H); or tyrosine (Y). In some embodiments, an aromatic amino acid residue is phenylalanine (F); tryptophan (W); or tyrosine (Y).

Pep^(N) and pep^(C) independently are peptide sequences or are absent. The peptide sequences can be natural, unnatural, or synthetic.

Tran^(N) and tran^(C) independently are transducing sequences as described herein or are absent.

Cap^(N) is a capping group at the N-terminus of a peptide. When two cap^(N) groups are attached to the same nitrogen, the two groups can be the same or different. Non-limiting examples of cap^(N) include H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, and an aminocarbonyl group. A cap^(N) group together with the nitrogen atom to which the cap^(N) group is bound can form, for example, an amide, a carbamate, a urethane, a heterocycle, or an amine Two cap^(N) groups bound to the same nitrogen atom can form together with the nitrogen atom a heterocycle.

Cap^(C) is a capping group at the C-terminus of a peptide. Non-limiting examples of cap^(C) groups include OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, and a heterocycle. A cap^(C) group together with the carbonyl to which the cap^(C) group is bound can form, for example, a carboxylic acid, an ester, or an amide.

In some embodiments, cap^(N) is H. In some embodiments, cap^(C) is OH. In some embodiments, cap^(N) is H and cap^(C) is OH.

Any side chain of any amino acid residue can be capped with any suitable capping group described herein.

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; 363-369; and 378. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; and 363-368. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 177-186. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 317-361. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 363-369 and 378. In some embodiments, the peptide is SEQ ID NO: 369. In some embodiments, the peptide is SEQ ID NO: 378. In some embodiments, the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a method of improving normal hearing, the method comprising administering a therapeutically-effective amount of a peptide of Formula (III) or Formula (IV) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-tran^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (III),

(cap^(N))(cap^(N))N-tran^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (IV), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (III). In some embodiments, the peptide is a peptide of Formula (IV). In some embodiments, the peptide is a peptide of either Formula (III) or Formula (IV).

In some embodiments, the invention provides a method of improving normal hearing, the method comprising administering a therapeutically-effective amount of a peptide of Formula (V) or Formula (VI) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (V),

(cap^(N))(cap^(N))N-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (VI), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(C) is a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (V). In some embodiments, the peptide is a peptide of Formula (VI). In some embodiments, the peptide is a peptide of either Formula (V) or Formula (VI).

In some embodiments, the invention provides a method of improving normal hearing, the method comprising administering a therapeutically-effective amount of a peptide to a subject in need or want thereof, wherein the peptide comprises: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing.

A stereoisomer can be any form of stereoisomer described herein.

The optional capping groups on the N-terminus, the C-terminus, and each amino acid residue side chain can be any suitable capping group described herein.

The peptide can further comprise a transducing sequence. The transducing sequence can be any transducing sequence described herein. The transducing sequence can be positioned at either the N- or the C-terminus of the peptide. In some embodiments, the transducing sequence is positioned at the C-terminus of the peptide. The transducing sequence can be any poly-arginine sequence described herein.

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; 379; 380; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 187-316. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 381-396. In some embodiments, the peptide is SEQ ID NO: 379. In some embodiments, the peptide is SEQ ID NO: 380. In some embodiments, the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of noise-induced hearing loss, wherein the compound is a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (I). In some embodiments, the peptide is a peptide of Formula (II). In some embodiments, the peptide is a peptide of either Formula (I) or Formula (II).

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; 363-369; and 378. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; and 363-368. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 177-186. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 317-361. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 363-369 and 378. In some embodiments, the peptide is SEQ ID NO: 369. In some embodiments, the peptide is SEQ ID NO: 378. In some embodiments, the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of noise-induced hearing loss, wherein the compound is a peptide of Formula (III) or Formula (IV),

(cap^(N))(cap^(N))N-tran^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (III),

(cap^(N))(cap^(N))N-tran^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (IV), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (III). In some embodiments, the peptide is a peptide of Formula (IV). In some embodiments, the peptide is a peptide of either Formula (III) or Formula (IV).

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of noise-induced hearing loss, wherein the compound is a peptide of Formula (V) or Formula (VI),

(cap^(N))(cap^(N))N-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (V),

(cap^(N))(cap^(N))N-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (VI), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(C) is a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (V). In some embodiments, the peptide is a peptide of Formula (VI). In some embodiments, the peptide is a peptide of either Formula (V) or Formula (VI).

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of noise-induced hearing loss, wherein the compound is a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing.

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; 379; 380; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 187-316. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 381-396. In some embodiments, the peptide is SEQ ID NO: 379. In some embodiments, the peptide is SEQ ID NO: 380. In some embodiments, the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of age-related hearing loss, wherein the compound is a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (I). In some embodiments, the peptide is a peptide of Formula (II). In some embodiments, the peptide is a peptide of either Formula (I) or Formula (II).

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; 363-369; and 378. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; and 363-368. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 177-186. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 317-361. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 363-369 and 378. In some embodiments, the peptide is SEQ ID NO: 369. In some embodiments, the peptide is SEQ ID NO: 378. In some embodiments, the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of age-related hearing loss, wherein the compound is a peptide of Formula (III) or Formula (IV),

(cap^(N))(cap^(N))N-tran^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (III),

(cap^(N))(cap^(N))N-tran^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (IV), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (III). In some embodiments, the peptide is a peptide of Formula (IV). In some embodiments, the peptide is a peptide of either Formula (III) or Formula (IV).

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of age-related hearing loss, wherein the compound is a peptide of Formula (V) or Formula (VI),

(cap^(N))(cap^(N))N-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (V),

(cap^(N))(cap^(N))N-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (VI), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(C) is a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (V). In some embodiments, the peptide is a peptide of Formula (VI). In some embodiments, the peptide is a peptide of either Formula (V) or Formula (VI).

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of age-related hearing loss, wherein the compound is a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing.

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; 379; 380; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 187-316. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 381-396. In some embodiments, the peptide is SEQ ID NO: 379. In some embodiments, the peptide is SEQ ID NO: 380. In some embodiments, the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the improvement of normal hearing, wherein the compound is a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (I). In some embodiments, the peptide is a peptide of Formula (II). In some embodiments, the peptide is a peptide of either Formula (I) or Formula (II).

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; 363-369; and 378. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; and 363-368. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 177-186. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 317-361. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 363-369 and 378. In some embodiments, the peptide is SEQ ID NO: 369. In some embodiments, the peptide is SEQ ID NO: 378. In some embodiments, the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the improvement of normal hearing, wherein the compound is a peptide of Formula (III) or Formula (IV),

(cap^(N))(cap^(N))N-tran^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (III),

(cap^(N))(cap^(N))N-tran^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (IV), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (III). In some embodiments, the peptide is a peptide of Formula (IV). In some embodiments, the peptide is a peptide of either Formula (III) or Formula (IV).

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the improvement of normal hearing, wherein the compound is a peptide of Formula (V) or Formula (VI),

(cap^(N))(cap^(N))N-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (V),

(cap^(N))(cap^(N))N-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (VI), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(C) is a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (V). In some embodiments, the peptide is a peptide of Formula (VI). In some embodiments, the peptide is a peptide of either Formula (V) or Formula (VI).

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the improvement of normal hearing, wherein the compound is a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing.

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; 379; 380; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 187-316. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 381-396. In some embodiments, the peptide is SEQ ID NO: 379. In some embodiments, the peptide is SEQ ID NO: 380. In some embodiments, the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a compound for use in the treatment of noise-induced hearing loss, wherein the compound is a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (I). In some embodiments, the peptide is a peptide of Formula (II). In some embodiments, the peptide is a peptide of either Formula (I) or Formula (II).

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; 363-369; and 378. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; and 363-368. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 177-186. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 317-361. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 363-369 and 378. In some embodiments, the peptide is SEQ ID NO: 369. In some embodiments, the peptide is SEQ ID NO: 378. In some embodiments, the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a compound for use in the treatment of noise-induced hearing loss, wherein the compound is a peptide of Formula (III) or Formula (IV),

(cap^(N))(cap^(N))N-tran^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (III),

(cap^(N))(cap^(N))N-tran^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (IV), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (III). In some embodiments, the peptide is a peptide of Formula (IV). In some embodiments, the peptide is a peptide of either Formula (III) or Formula (IV).

In some embodiments, the invention provides a compound for use in the treatment of noise-induced hearing loss, wherein the compound is a peptide of Formula (V) or Formula (VI),

(cap^(N))(cap^(N))N-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (V),

(cap^(N))(cap^(N))N-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (VI), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(C) is a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (V). In some embodiments, the peptide is a peptide of Formula (VI). In some embodiments, the peptide is a peptide of either Formula (V) or Formula (VI).

In some embodiments, the invention provides a compound for use in the treatment of noise-induced hearing loss, wherein the compound is a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing.

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; 379; 380; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 187-316. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 381-396. In some embodiments, the peptide is SEQ ID NO: 379. In some embodiments, the peptide is SEQ ID NO: 380. In some embodiments, the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a compound for use in the treatment of age-related hearing loss, wherein the compound is a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (I). In some embodiments, the peptide is a peptide of Formula (II). In some embodiments, the peptide is a peptide of either Formula (I) or Formula (II).

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; 363-369; and 378. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; and 363-368. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 177-186. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 317-361. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 363-369 and 378. In some embodiments, the peptide is SEQ ID NO: 369. In some embodiments, the peptide is SEQ ID NO: 378. In some embodiments, the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a compound for use in the treatment of age-related hearing loss, wherein the compound is a peptide of Formula (III) or Formula (IV),

(cap^(N))(cap^(N))N-tran^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (III),

(cap^(N))(cap^(N))N-tran^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (IV), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (III). In some embodiments, the peptide is a peptide of Formula (IV). In some embodiments, the peptide is a peptide of either Formula (III) or Formula (IV).

In some embodiments, the invention provides a compound for use in the treatment of age-related hearing loss, wherein the compound is a peptide of Formula (V) or Formula (VI),

(cap^(N))(cap^(N))N-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (V),

(cap^(N))(cap^(N))N-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (VI), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(C) is a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (V). In some embodiments, the peptide is a peptide of Formula (VI). In some embodiments, the peptide is a peptide of either Formula (V) or Formula (VI).

In some embodiments, the invention provides a compound for use in the treatment of age-related hearing loss, wherein the compound is a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing.

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; 379; 380; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 187-316. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 381-396. In some embodiments, the peptide is SEQ ID NO: 379. In some embodiments, the peptide is SEQ ID NO: 380. In some embodiments, the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a compound for use in the improvement of normal hearing, wherein the compound is a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (I). In some embodiments, the peptide is a peptide of Formula (II). In some embodiments, the peptide is a peptide of either Formula (I) or Formula (II).

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; 363-369; and 378. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; and 363-368. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 177-186. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 317-361. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 363-369 and 378. In some embodiments, the peptide is SEQ ID NO: 369. In some embodiments, the peptide is SEQ ID NO: 378. In some embodiments, the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a compound for use in the improvement of normal hearing, wherein the compound is a peptide of Formula (III) or Formula (IV),

(cap^(N))(cap^(N))N-tran^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (III),

(cap^(N))(cap^(N))N-tran^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (IV), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (III). In some embodiments, the peptide is a peptide of Formula (IV). In some embodiments, the peptide is a peptide of either Formula (III) or Formula (IV).

In some embodiments, the invention provides a compound for use in the improvement of normal hearing, wherein the compound is a peptide of Formula (V) or Formula (VI),

(cap^(N))(cap^(N))N-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-tran^(C)-C(O)-cap^(C)  Formula (V),

(cap^(N))(cap^(N))N-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-tran^(C)-C(O)-cap^(C)  Formula (VI), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(C) is a transducing sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁶ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is a peptide of Formula (V). In some embodiments, the peptide is a peptide of Formula (VI). In some embodiments, the peptide is a peptide of either Formula (V) or Formula (VI).

In some embodiments, the invention provides a compound for use in the improvement of normal hearing, wherein the compound is a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing.

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; 379; 380; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; and 381-396. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 187-316. In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 381-396. In some embodiments, the peptide is SEQ ID NO: 379. In some embodiments, the peptide is SEQ ID NO: 380. In some embodiments, the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a method of treating noise-induced hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of any one of SEQ ID NOs: 1-369 and 378-396 to a subject in need or want thereof, or a stereoisomer or pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a method of treating noise-induced hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of any one of SEQ ID NOs: 1-369 and 378-396 to a subject in need or want thereof, or a pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a method of treating age-related hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of any one of SEQ ID NOs: 1-369 and 378-396 to a subject in need or want thereof, or a stereoisomer or pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a method of treating age-related hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of any one of SEQ ID NOs: 1-369 and 378-396 to a subject in need or want thereof, or a pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a method of improving normal hearing, the method comprising administering a therapeutically-effective amount of a peptide of any one of SEQ ID NOs: 1-369 and 378-396 to a subject in need or want thereof, or a stereoisomer or pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a method of improving normal hearing, the method comprising administering a therapeutically-effective amount of a peptide of any one of SEQ ID NOs: 1-369 and 378-396 to a subject in need or want thereof, or a pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a use of a peptide in the preparation of a medicament for the treatment of noise-induced hearing loss, wherein the peptide is a peptide of any one of SEQ ID NOs: 1-369 and 378-396, or a stereoisomer or pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a use of a peptide in the preparation of a medicament for the treatment of noise-induced hearing loss, wherein the peptide is a peptide of any one of SEQ ID NOs: 1-369 and 378-396, or a pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a use of a peptide in the preparation of a medicament for the treatment of age-related hearing loss, wherein the peptide is a peptide of any one of SEQ ID NOs: 1-369 and 378-396, or a stereoisomer or pharmaceutically-acceptable salt thereof.

In some embodiments, the invention provides a use of a peptide in the preparation of a medicament for the treatment of age-related hearing loss, wherein the peptide is a peptide of any one of SEQ ID NOs: 1-369 and 378-396, or a pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a use of a peptide in the preparation of a medicament for the improvement of normal hearing, wherein the peptide is a peptide of any one of SEQ ID NOs: 1-369 and 378-396, or a stereoisomer or pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a use of a peptide in the preparation of a medicament for the improvement of normal hearing, wherein the peptide is a peptide of any one of SEQ ID NOs: 1-369 and 378-396, or a pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a peptide for use in the treatment of noise-induced hearing loss, wherein the peptide is a peptide of any one of SEQ ID NOs: 1-369 and 378-396, or a stereoisomer or pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a peptide for use in the treatment of noise-induced hearing loss, wherein the peptide is a peptide of any one of SEQ ID NOs: 1-369 and 378-396, or a pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a peptide for use in the treatment of age-related hearing loss, wherein the peptide is a peptide of any one of SEQ ID NOs: 1-369 and 378-396, or a stereoisomer or pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a peptide for use in the treatment of age-related hearing loss, wherein the peptide is a peptide of any one of SEQ ID NOs: 1-369 and 378-396, or a pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a peptide for use in the improvement of normal hearing, wherein the peptide is a peptide of any one of SEQ ID NOs: 1-369 and 378-396, or a stereoisomer or pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

In some embodiments, the invention provides a peptide for use in the improvement of normal hearing, wherein the peptide is a peptide of any one of SEQ ID NOs: 1-369 and 378-396, or a pharmaceutically-acceptable salt thereof. In some embodiments, the peptide is not any one of SEQ ID NOs: 369 and 378-380.

The invention provides the use of pharmaceutically-acceptable salts of any peptide described herein. Pharmaceutically-acceptable salts include, for example, acid-addition salts and base-addition salts. The acid that is added to the peptide to form an acid-addition salt can be an organic acid or an inorganic acid. A base that is added to the peptide to form a base-addition salt can be an organic base or an inorganic base. In some embodiments, a pharmaceutically-acceptable salt is a metal salt. In some embodiments, a pharmaceutically-acceptable salt is an ammonium salt.

Metal salts can arise from the addition of an inorganic base to a peptide of the invention. The inorganic base consists of a metal cation paired with a basic couterion, such as, for example, hydroxide, carbonate, bicarbonate, or phosphate. The metal can be an alkali metal, alkaline earth metal, transition metal, or main group metal. In some embodiments, the metal is lithium, sodium, potassium, cesium, cerium, magnesium, manganese, iron, calcium, strontium, cobalt, titanium, aluminum, copper, cadmium, or zinc.

In some embodiments, a metal salt is a lithium salt, a sodium salt, a potassium salt, a cesium salt, a cerium salt, a magnesium salt, a manganese salt, a iron salt, a calcium salt, a strontium salt, a cobalt salt, a titanium salt, a aluminum salt, a copper salt, a cadmium salt, or a zinc salt.

Ammonium salts can arise from the addition of ammonia or an organic amine to a peptide of the invention. In some embodiments, the organic amine is triethyl amine, diisopropyl amine, ethanol amine, diethanol amine, triethanol amine, morpholine, N-methylmorpholine, piperidine, N-methylpiperidine, N-ethylpiperidine, dibenzylamine, piperazine, pyridine, pyrrazole, pipyrrazole, imidazole, pyrazine, or pipyrazine.

In some embodiments, an ammonium salt is a triethyl amine salt, a diisopropyl amine salt, an ethanol amine salt, a diethanol amine salt, a triethanol amine salt, a morpholine salt, an N-methylmorpholine salt, a piperidine salt, an N-methylpiperidine salt, an N-ethylpiperidine salt, a dibenzylamine salt, a piperazine salt, a pyridine salt, a pyrrazole salt, a pipyrrazole salt, an imidazole salt, a pyrazine salt, or a pipyrazine salt.

Acid addition salts can arise from the addition of an acid to a peptide of the invention. In some embodiments, the acid is organic. In some embodiments, the acid is inorganic. In some embodiments, the acid is hydrochloric acid, hydrobromic acid, hydroiodic acid, nitric acid, nitrous acid, sulfuric acid, sulfurous acid, a phosphoric acid, isonicotinic acid, lactic acid, salicylic acid, tartaric acid, ascorbic acid, gentisinic acid, gluconic acid, glucaronic acid, saccaric acid, formic acid, benzoic acid, glutamic acid, pantothenic acid, acetic acid, propionic acid, butyric acid, fumaric acid, succinic acid, methanesulfonic acid, ethanesulfonic acid, benzenesulfonic acid, p-toluenesulfonic acid, citric acid, oxalic acid, or maleic acid.

In some embodiments, the salt is a hydrochloride salt, a hydrobromide salt, a hydroiodide salt, a nitrate salt, a nitrite salt, a sulfate salt, a sulfite salt, a phosphate salt, isonicotinate salt, a lactate salt, a salicylate salt, a tartrate salt, an ascorbate salt, a gentisinate salt, a gluconate salt, a glucaronate salt, a saccarate salt, a formate salt, a benzoate salt, a glutamate salt, a pantothenate salt, an acetate salt, a propionate salt, a butyrate salt, a fumarate salt, a succinate salt, a methanesulfonate salt, an ethanesulfonate salt, a benzenesulfonate salt, a p-toluenesulfonate salt, a citrate salt, an oxalate salt, or a maleate salt.

In some embodiments, the invention provides an analogue of any peptide disclosed herein, wherein the analogue possesses any number of amino acid residues that are conservative substitutions of the amino acid residues of the peptide disclosed herein.

In some embodiments, a peptide of any one of Formulae I, II, III, IV, V, and VI is a peptide of Table 1. In some embodiments, a peptide of any one of Formulae I, II, III, IV, V, and VI is not a peptide of Table 1. In some embodiments, a peptide of any one of Formulae I, II, III, IV, V, and VI is not any one of SEQ ID NOS: 1-369 and 378-380. In some embodiments, a peptide of any one of Formulae I, III, and V is not SEQ ID NO: 369. In some embodiments, a peptide of any one of Formulae I, III, and V is not SEQ ID NO: 378.

In some embodiments, a peptide comprising the amino acid sequence EEYFM (SEQ ID NO: 305) is not SEQ ID NO: 379. In some embodiments, a peptide comprising the amino acid sequence EEYFM (SEQ ID NO: 305) is not SEQ ID NO: 380.

Administration

A pharmaceutical composition containing a peptide can be administered to patients along with pharmaceutical excipients or diluents. Non-limiting examples of suitable pharmaceutical excipients or diluents include starch, glucose, lactose, sucrose, gelatin, malt, rice, flour, chalk, silica gel, magnesium carbonate, magnesium stearate, sodium stearate, glycerol monostearate, talc, sodium chloride, dried skim milk, glycerol, propylene, glycol, water, ethanol, buffered water, phosphate buffered saline and the like. These compositions can take the form of drops, solutions, suspensions, tablets, pills, capsules, powders, sustained-release formulations and the like. In some embodiments, the composition is an ear drop. In another preferred embodiment the composition containing a peptide in any form could be further modulated using suitable excipients and diluents including lactose, dextrose, sucrose, sorbitol, mannitol, starches, gum acacia, calcium phosphate, alginates, tragacanth, gelatin, calcium silicate, microcrystalline cellulose, polyvinylpyrrolidone, cellulose, water syrup, methyl cellulose, methyl and propylhydroxybenzoates, talc, magnesium stearate and mineral oil. The formulations can additionally include lubricating agents, wetting agents, emulsifying and suspending agents, preserving agents, sweetening agents or flavoring agents. The compositions can be formulated in a unit dosage form, each dosage containing, for example, from about 1 ng to 1000 mg of the peptide. In some embodiments, a dose contains from 100-1000 mg of the peptide. In some embodiments, a dose contains from 100-500 mg of the peptide. In some embodiments, a dose contains from 200-300 mg of the peptide The term, “unit dosage form,” refers to physically discrete units suitable as unitary dosages for human subjects and other mammals, each unit containing a predetermined quantity of active material calculated to produce the desired therapeutic effect, in association with a suitable pharmaceutical diluents or excipients. These may be administered to humans, domestic pets, livestock, or other animals with a pharmaceutically-acceptable diluents or excipients, in unit dosage form. Administration may be topical, intraaural, parenteral, intravenous, intra-arterial, subcutaneous, intramuscular, intracranial, intraorbital, ophthalmic, intraventricular, intracapsular, intraspinal, intracisternal, intraperitoneal, intranasal, aerosol, by suppositories, or oral administration. Formulations for oral use include tablets containing the active ingredient(s) in a mixture with non-toxic pharmaceutically-acceptable excipients. These excipients may be, for example, inert diluents or fillers (e.g., sucrose and sorbitol), lubricating agents, glidants, and antiadhesives (e.g., magnesium stearate, zinc stearate, stearic acid, silicas, hydrogenated vegetable oils, or talc).

The active therapeutic formulation of the invention can be provided in lyophilized form for reconstituting, for instance, in isotonic, aqueous, or saline buffers for parental, subcutaneous, intradermal, intramuscular, or intravenous administration. The subject composition of the invention may also be administered to the patient in need of a therapeutic peptide by liquid preparations for orifice, e.g. oral, intraaural, nasal, or sublingual, administration such as suspensions, syrups or elixirs. The subject composition of the invention may also be prepared for oral administration such as capsules, tablets, pills, and the like, as well as chewable solid formulations. The subject composition of the invention may also be prepared as a cream for dermal administration such as liquid, viscous liquid, paste, or powder. The subject composition of the invention may also be prepared as powder for lung administration with or without aerosolizing component. The composition of the invention can be prepared as a drop, for example, an ear drop.

The presently disclosed compositions can be used for delivery in oral, intraaural, intranasal, sublingual, intraduodenal, subcutaneous, buccal, intracolonic, rectal, vaginal, mucosal, pulmonary, transdermal, intradermal, parenteral, intravenous, intramuscular and ocular forms as well as being able to traverse the blood-brain barrier.

Dosages

The dosage of any peptide of the present invention will vary depending on the symptoms, age and body weight of the patient, the nature and severity of the disorder to be treated or prevented, the route of administration, and the form of the composition. Any of the subject formulations may be administered in a single dose or in divided doses. Dosages for the peptides of the present invention may be readily determined by techniques known to those of skill in the art or as taught herein. Also, the present invention contemplates mixtures of more than one subject peptide, as well as other therapeutic agents.

In certain embodiments, the dosage of the subject peptide will generally be in the range of about 0.01 ng to about 10 g per kg body weight, specifically in the range of about 1 ng to about 0.1 g per kg, and more specifically in the range of about 100 ng to about 10 mg per kg.

An effective dose or amount, and any possible affects on the timing of administration of the formulation, may need to be identified for any particular peptide of the present invention. This end may be accomplished by routine experiment as described herein, using one or more groups of animals, or in human trials if appropriate. The effectiveness of any peptide and method of treatment or prevention may be assessed by administering the supplement and assessing the effect of the administration by measuring one or more indices associated with the neoplasm of interest, and comparing the post-treatment values of these indices to the values of the same indices prior to treatment.

The precise time of administration and amount of any particular peptide that will yield the most effective treatment in a given patient will depend upon the activity, pharmacokinetics, and bioavailability of a particular peptide, physiological condition of the patient (including age, sex, disease type and stage, general physical condition, responsiveness to a given dosage and type of medication), route of administration, and the like. The guidelines presented herein may be used to optimize the treatment, e.g., determining the optimum time and/or amount of administration, which will require no more than routine experimentation consisting of monitoring the subject and adjusting the dosage and/or timing.

While the subject is being treated, the health of the subject may be monitored by measuring one or more of the relevant indices at predetermined times during a 24-hour period. Treatment, including supplement, amounts, times of administration and formulation, may be optimized according to the results of such monitoring. The patient may be periodically reevaluated to determine the extent of improvement by measuring the same parameters, the first such reevaluation typically occurring at the end of four weeks from the onset of therapy, and subsequent reevaluations occurring every four to eight weeks during therapy and then every three months thereafter. Therapy may continue for several months or even years, with a minimum of one month being a typical length of therapy for humans. Adjustments to the amount(s) of peptide administered and possibly to the time of administration may be made based on these reevaluations.

Treatment may be initiated with smaller dosages which are less than the optimum dose of the peptide. Thereafter, the dosage may be increased by small increments until the optimum therapeutic effect is attained.

The combined use of several peptides of the present invention, or alternatively other peptides, may reduce the required dosage for any individual component because the onset and duration of effect of the different components may be complimentary. In such combined therapy, the different peptides may be delivered together or separately, and simultaneously or at different times within the day.

Toxicity and therapeutic efficacy of subject peptides may be determined by standard pharmaceutical procedures in cell cultures or experimental animals, e.g., for determining the LD₅₀ and the ED₅₀. Although peptides that exhibit toxic side effects may be used, care should be taken to design a delivery system that targets the peptides to the desired site in order to reduce side effects.

The data obtained from cell culture assays and animal studies may be used in formulating a range of dosage for use in humans. The dosage of any supplement, or alternatively of any components therein, lies preferably within a range of circulating concentrations that include the ED₅₀, with little or no toxicity. The dosage may vary within this range depending upon the dosage form employed and the route of administration utilized. For peptides of the present invention, the therapeutically effective dose may be estimated initially from cell culture assays. A dose may be formulated in animal models to achieve a circulating plasma concentration range that includes the IC₅₀ (i.e., the concentration of the test peptide which achieves a half-maximal inhibition of symptoms) as determined in cell culture. Such information may be used to more accurately determine useful doses in humans. Levels in plasma may be measured, for example, by high performance liquid chromatography (HPLC).

Formulations

The peptide-based compositions of the present invention may be administered by various means, depending on their intended use, as is well known in the art. For example, if compositions of the present invention are to be administered orally, they may be formulated as tablets, capsules, granules, powders or syrups. Alternatively, formulations of the present invention may be administered parenterally as injections (intravenous, intramuscular or subcutaneous), drop infusion preparations or suppositories. The peptide-based compositions can also be administered into deep lung by aerosolizing the composition into 1-5 um particle using standard techniques known in the art either with or without addition of aerosolizing excipient. For application by the ophthalmic mucous membrane route, compositions of the present invention may be formulated as eye drops or eye ointments. Aural pharmaceutical compositions can be formulated as ear drops, ointments, creams, liquids, gels, or salves for application to the ear, either internally or superficially. These formulations may be prepared by conventional means, and, if desired, the compositions may be mixed with any conventional additive, such as an excipient, a binder, a disintegrating agent, a lubricant, a solubilizing agent, a suspension aid, an emulsifying agent or a coating agent.

In formulations of the subject invention, wetting agents, emulsifiers and lubricants, such as sodium lauryl sulfate and magnesium stearate, as well as coloring agents, release agents, coating agents, sweetening, flavoring and perfuming agents, preservatives and antioxidants may be present in the formulated agents.

Subject peptide-based compositions may be suitable for oral, intra-aural, nasal, topical (including buccal and sublingual), rectal, vaginal, aerosol and/or parenteral administration. The formulations of the peptide-based compositions may conveniently be presented in unit dosage form and may be prepared by any methods well known in the art of pharmacy. The amounts of composition that may be combined with other excipients to produce a single dose may vary depending upon the subject being treated, and the particular mode of administration.

Formulations suitable for oral administration may be in the form of capsules, cachets, pills, tablets, lozenges (using a flavored basis, usually sucrose and acacia or tragacanth), powders, granules, or as a solution or a suspension in an aqueous or non-aqueous liquid, or as an oil-in-water or water-in-oil liquid emulsion, or as an elixir or syrup, or as pastilles (using an inert base, such as gelatin and glycerin, or sucrose and acacia), each containing a predetermined amount of a subject composition thereof as an active ingredient. Compositions of the present invention may also be administered as a bolus, electuary, or paste.

In solid dosage forms for oral administration (capsules, tablets, pills, dragees, powders, granules and the like), the subject peptide composition is mixed with one or more pharmaceutically-acceptable carriers, such as sodium citrate or dicalcium phosphate, and/or any of the following: (1) fillers or extenders, such as starches, lactose, sucrose, glucose, mannitol, and/or silicic acid; (2) binders, such as carboxymethyl cellulose, alginates, gelatin, polyvinyl pyrrolidone, sucrose and/or acacia; (3) humectants, such as glycerol; (4) disintegrating agents, such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and sodium carbonate; (5) solution retarding agents, such as paraffin; (6) absorption accelerators, such as quaternary ammonium compounds; (7) wetting agents, such as acetyl alcohol and glycerol monostearate; (8) absorbents, such as kaolin and bentonite clay; (9) lubricants, such as talc, calcium stearate, magnesium stearate, solid polyethylene glycols, sodium lauryl sulfate, and mixtures thereof; and (10) coloring agents. In the case of capsules, tablets and pills, the peptide compositions may also comprise buffering agents. Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugars, as well as high molecular weight polyethylene glycols and the like.

A tablet may be made by compression or molding, optionally with one or more accessory ingredients. Compressed tablets may be prepared using binder (for example, gelatin or hydroxypropylmethyl cellulose), lubricant, inert diluent, preservative, disintegrant (for example, sodium starch glycolate or cross-linked sodium carboxymethyl cellulose), surface-active or dispersing agent. Molded tablets may be made by molding in a suitable machine a mixture of the subject composition moistened with an inert liquid diluent. Tablets, and other solid dosage forms, such as dragees, capsules, pills and granules, may optionally be scored or prepared with coatings and shells, such as enteric coatings and other coatings well known in the pharmaceutical-formulating art.

Liquid dosage forms for oral administration include pharmaceutically-acceptable emulsions, microemulsions, gels, solutions, suspensions, syrups and elixirs. The liquid dosage peptide formulation may contain inert diluents commonly used in the art, such as, for example, water or other solvents, solubilizing agents and emulsifiers, such as ethyl alcohol, isopropyl alcohol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1,3-butylene glycol, oils (in particular, cottonseed, groundnut, corn, germ, olive, castor and sesame oils), glycerol, tetrahydrofuryl alcohol, polyethylene glycols and fatty acid esters of sorbitan, and mixtures thereof.

Suspension dosage of the peptide formulation may contain suspending agents as, for example, ethoxylated isostearyl alcohols, polyoxyethylene sorbitol and sorbitan esters, microcrystalline cellulose, aluminum metahydroxide, bentonite, agar-agar and tragacanth, and mixtures thereof.

The peptide formulations for rectal or vaginal administration may be presented as a suppository, which may be prepared by mixing a peptide with one or more suitable carriers and other excipients comprising, for example, cocoa butter, polyethylene glycol, a suppository wax or a salicylate, and which is solid at room temperature, but liquid at body temperature and, therefore, will melt in the body cavity and release peptide. Formulations which are suitable for vaginal administration also include pessaries, tampons, creams, gels, pastes, foams or spray formulations containing excipients as are known in the art to be appropriate.

The peptide dosage formulations for transdermal administration of a subject composition includes drops, powders, sprays, ointments, pastes, creams, lotions, gels, solutions, patches and inhalants. The active component may be mixed under sterile conditions with a pharmaceutically-acceptable carrier, and with any preservatives, buffers, or propellants which may be required.

The ointments, pastes, creams and gels may contain, in addition to a subject composition, excipients, such as animal and vegetable fats, oils, waxes, paraffin, starch, tragacanth, cellulose derivatives, polyethylene glycols, silicones, bentonite, silicic acid, talc and zinc oxide, or mixtures thereof. The peptide compositions of the present invention may also be in the form of baby wipes.

Powders and sprays may contain, in addition to a subject composition, excipients such as lactose, talc, silicic acid, aluminum hydroxide, calcium silicates and polyamide powder, or mixtures of these substances. Sprays may additionally contain customary propellants, such as chlorofluorohydrocarbons and volatile unsubstituted hydrocarbons, such as butane and propane.

The peptide compositions of the present invention may alternatively be administered by aerosol. This is accomplished by preparing an aqueous aerosol, liposomal preparation or solid particles containing the compound. A non-aqueous (e.g., fluorocarbon propellant) suspension could be used. Sonic nebulizers may be used because they minimize exposing the peptide to shear, which may result in degradation of the peptides contained in the subject compositions.

Ordinarily, an aqueous aerosol is made by formulating an aqueous solution or suspension of a subject composition together with conventional pharmaceutically-acceptable carriers and stabilizers. The carriers and stabilizers vary with the requirements of the particular subject composition, but typically include non-ionic surfactants (Tweens, Pluronics, or polyethylene glycol), innocuous proteins like serum albumin, sorbitan esters, oleic acid, lecithin, amino acids such as glycine, buffers, salts, sugars or sugar alcohols. Aerosols generally are prepared from isotonic solutions.

Pharmaceutical compositions of this invention suitable for parenteral administration comprise a subject composition in combination with one or more pharmaceutically-acceptable sterile isotonic aqueous or non-aqueous solutions, dispersions, suspensions or emulsions, or sterile powders which may be reconstituted into sterile injectable solutions or dispersions just prior to use, which may contain antioxidants, buffers, bacteriostats, solutes which render the formulation isotonic with the blood of the intended recipient or suspending or thickening agents.

Examples of suitable aqueous and non-aqueous carriers which may be employed in the pharmaceutical compositions of the invention include water, ethanol, polyols (such as glycerol, propylene glycol, polyethylene glycol, and the like), and suitable mixtures thereof, vegetable oils, such as olive oil, and injectable organic esters, such as ethyl oleate. Proper fluidity may be maintained, for example, by the use of coating materials, such as lecithin, by the maintenance of the required particle size in the case of dispersions, and by the use of surfactants.

In some embodiments, the invention provides a method of treating noise-induced hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of Formula (I) or Formula (II) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof, wherein the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a method of treating age-related hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of Formula (I) or Formula (II) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof, wherein the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a method of improving normal hearing, the method comprising administering a therapeutically-effective amount of a peptide of Formula (I) or Formula (II) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof, wherein the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the peptide is a peptide of Formula (I).

In some embodiments, X¹ is A, D, E, K or is absent; X⁴ is A, E, H, I, K, R, or Y; X⁸ is A, F, P, S, T, W, or Y; and X⁹ is A, D, E, or K.

In some embodiments, cap^(N) is H and cap^(C) is OH.

In some embodiments, at least one amino acid residue of the peptide possesses the D-configuration.

In some embodiments, at least one of amino acid residues X¹⁻¹¹ possesses the D-configuration.

In some embodiments, pep^(N), pep^(C), and tran^(N) are absent, and tran^(C) is a transducing sequence.

In some embodiments, the transducing sequence is a poly-arginine sequence.

In some embodiments, the poly-arginine sequence consists of about nine arginine residues.

In some embodiments, at least one arginine residue of the poly-arginine sequence possesses the D-configuration.

In some embodiments, each residue of the poly-arginine sequence possesses the D-configuration.

In some embodiments, the peptide is administered orally, topically, intraaurally, parenterally, intravenously, intra-arterially, subcutaneously, intramuscularly, intracranially, or intranasally.

In some embodiments, the peptide is administered topically.

In some embodiments, the peptide is administered to the skin, hair, outer ear, tympanic membrane, buccal cavity, nasal cavity, or sublingual cavity.

In some embodiments, the peptide is administered to the tympanic membrane.

In some embodiments, the peptide is administered in the form of a drop.

In some embodiments, the subject is a human.

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; and 363-368.

In some embodiments, the invention provides a method of treating noise-induced hearing loss, the method comprising administering a therapeutically-effective amount of a peptide to a subject in need or want thereof, wherein the peptide comprises: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing, wherein the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a method of treating age-related hearing loss, the method comprising administering a therapeutically-effective amount of a peptide to a subject in need or want thereof, wherein the peptide comprises: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing, wherein the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a method of improving normal hearing, the method comprising administering a therapeutically-effective amount of a peptide to a subject in need or want thereof, wherein the peptide comprises: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing, wherein the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the peptide comprises IGLCA (SEQ ID NO: 207).

In some embodiments, the peptide comprises YIKVQ (SEQ ID NO: 227).

In some embodiments, the peptide comprises LFNEI (SEQ ID NO: 252).

In some embodiments, the peptide comprises EMFTI (SEQ ID NO: 276).

In some embodiments, the peptide comprises YRGLL (SEQ ID NO: 287).

In some embodiments, the peptide comprises RIKYG (SEQ ID NO: 304).

In some embodiments, the peptide comprises EEYFM (SEQ ID NO: 305).

In some embodiments, the peptide further comprises a transducing sequence.

In some embodiments, the transducing sequence is positioned at the C-terminus of the peptide.

In some embodiments, the transducing sequence is a poly-arginine sequence.

In some embodiments, the poly-arginine sequence consists of about nine arginine residues.

In some embodiments, at least one amino acid residue of the peptide possesses the D-configuration.

In some embodiments, at least one arginine residue of the poly-arginine sequence possesses the D-configuration.

In some embodiments, each residue of the poly-arginine sequence possesses the D-configuration.

In some embodiments, the peptide is administered orally, topically, intraaurally, parenterally, intravenously, intra-arterially, subcutaneously, intramuscularly, intracranially, or intranasally.

In some embodiments, the peptide is administered topically.

In some embodiments, the peptide is administered to the skin, hair, outer ear, tympanic membrane, buccal cavity, nasal cavity, or sublingual cavity.

In some embodiments, the peptide is administered to the tympanic membrane.

In some embodiments, the peptide is administered in the form of a drop.

In some embodiments, the subject is a human.

In some embodiments, the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; and 381-396.

In some embodiments, the invention provides a method of treating noise-induced hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof, to a subject in need or want thereof.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of noise-induced hearing loss, wherein the compound is a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof.

In some embodiments, the invention provides a compound for use in the treatment of noise-induced hearing loss, wherein the compound is a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof.

In some embodiments, the invention provides a method of treating age-related hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof, to a subject in need or want thereof.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of age-related hearing loss, wherein the compound is a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof.

In some embodiments, the invention provides a compound for use in the treatment of age-related hearing loss, wherein the compound is a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof.

In some embodiments, the invention provides a method of improving hearing, the method comprising administering a therapeutically-effective amount of a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof, to a subject in need or want thereof.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the improvement of hearing, wherein the compound is a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof.

In some embodiments, the invention provides a compound for use in the improvement of hearing, wherein the compound is a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof.

In some embodiments, the peptide is administered orally, topically, intraaurally, parenterally, intravenously, intra-arterially, subcutaneously, intramuscularly, intracranially, or intranasally.

In some embodiments, the peptide is administered topically.

In some embodiments, the peptide is administered to the skin, hair, outer ear, tympanic membrane, buccal cavity, nasal cavity, or sublingual cavity.

In some embodiments, the peptide is administered to the tympanic membrane.

In some embodiments, the peptide is administered in the form of a drop.

In some embodiments, the subject is a human.

EXAMPLES Example 1 Materials and Methods

Peptide of the Natural Configuration:

Peptides were synthesized by Mimotopes using their unique proprietary parallel array synthesis platform. Each peptide contains an amino acid sequence of the invention and optionally a 9-residue arginine cell transduction sequence positioned at the C-terminus of the peptide to facilitate cellular uptake. The peptides are presented in Table 1.

Peptides with D-Amino Acid Residues are Synthesized as Peptides with L-Amino Acid Residues are Synthesized.

The D-amino acids with the appropriate protecting groups are commercially available for use on automated systems to construct peptides. Peptides described herein can be made entirely from L-amino acids, entirely from D-amino acids, or from a mixture of both in any proportion. A peptide is considered stereochemically-mixed if the peptide comprises at least one L-, and at least one D-amino acid residue. The transduction tag can similarly be made entirely from L-amino acids, entirely from D-amino acids, or from a mixture of both in any proportion. Peptides differing only in stereochemistry may possess differing properties, benefits, specificities, affinities, and activities at the same or at different receptors. In some cases, peptides differing only in stereochemistry may exhibit comparable specificities and activities.

Each peptide is constructed both with and without a FITC-label (Fluorescein isothiocyanate). FITC labeled peptides are used for FACS analysis. The peptides lacking the FITC label are used for in vitro inhibition assays and in vivo treatment studies.

Reagents:

Nuclease-resistant phosphorylated oligonucleotide was purchased from Oligos Etc., Inc. The sequence was 5′-TCCATGACGTTCCTGACGTT-3′ (SEQ ID NO: 377) (CpG-oligodeoxynucleotide (ODN)). TNF-α assays were performed using assay kits purchased from R&D Systems. Mouse IL-1α and TNF-α were purchased from R&D Systems. PMA (phorbol myristate acetate) and LPS (Lipopolysaccaride) were purchased from Sigma. The TLR ligands flagellin, zymosan, and Poly (I:C) were purchased from Invivogen. Cytokine assays were performed using assay kits purchased from R&D Systems. (Heat-inactivated S. pneumoniae was the kind gift of Dr. Thomas DeMaria, The Ohio State University College of Medicine, Department of Otolaryngology, Columbus, Ohio.)

Cell Lines and Cultures:

RAW264.7 (murine monocyte/macrophage cells (American Type Culture Collection) were cultured at 37° C. in a 5% CO₂ humidified incubator and grown in DMEM (Invitrogen Life Technologies) supplemented with 10% (v/v) heat-inactivated FCS, 1.5 mM L-glutamine, 100 U/ml penicillin, and 100 μg/ml streptomycin.

Cytokine Secretion:

RAW264.7 cells were plated at 1.5×10⁵ cells/well-3×10⁵ cells/well in 48-well plates. After 24 hours, the cells were incubated with peptides at various concentrations at room temperature in triplicate either before, simultaneous with, or after activation with various PAMPs for 18 hours. Cell-free supernatants were analyzed for cytokines by ELISA, in quadruplicate. RAW264.7 cells were stimulated with either CpG-ODN (1 μg/ml or 1.25 μg/ml), LPS (about 1 ng/ml), Poly (I:C) (about 10 μg/ml), flagellin (about 5 ng/ml), or zymosan (about 10 μg/ml). Dose response curves were done with each PAMP to determine optimal stimulation concentration. For CpG-ODN stimulation, cells were incubated for 4 hours at 37° C., supernatants collected, and TNF-α measured by ELISA. Any cytokine involved in inflammatory disease mediated toll receptor signaling can be measured using similar assays.

Flow Cytometry:

Cells are analyzed by flow cytometry (FACScan, Becton Dickinson) using Cellquest software to quantify internalization of peptides. Gates are drawn to exclude dead cells based on 7-AAD (7-amino-actinomycin D) staining. Fluorescence due to cell-surface binding of FITC-labeled peptides is quenched using trypan blue. Data obtained are geometric mean fluorescent units (F) with background autofluorescence subtracted.

Immunoblotting:

RAW264.7 cells (6×10⁵) are plated in 12 well plates overnight. Cells are incubated for 15 minutes at room temperature with peptides to be tested or control scrambled peptides, and then stimulated with medium or LPS (1 ng/ml) for either 15 or 30 minutes. Cells are lysed, and proteins fractionated by SDS/PAGE (Sodium Dodecyl Sulfate/Polyacrylamide Gel Electrophoresis) (12%) Immunoblotting is done using Phospho-IkB-α (Ser32) antibody (Cell Signaling), detected using horseradish peroxidase-conjugated secondary antibody, and visualized by chemiluminescence. Measurements of band intensity are made using the Nucleo Tech Gel Expert software linked to an Epson expression 636 scanner and expressed as intensity/area.

Cell Viability:

Cells were assayed for viability using CellTiter 96 Aq_(ueous) One Solution Cell Proliferation Assay (Promega) following manufacturer's instructions. Briefly, cells were seeded in 96 well plates and incubated overnight at 37° C. in a humidified 5% CO₂ atmosphere. When samples were ready to be assayed, 20 μl of reagent was added into each well, and incubated for 1.5 hrs at 37° C. in a humidified 5% CO₂ atmosphere. Absorbances were read at 490 nm using an ELx800 absorbance microplate reader (BioTek) and data analyzed with Gen5 software (BioTek). Some peptides were evaluated for their effect on cell viability by trypan blue exclusion staining over a range of concentrations and then each peptide was tested for cytokine inhibition at the maximum concentration that had no effect on cell viability.

Example 2 Effect of Peptides on CpG-ODN-Induced Cytokine Secretion

The effect of several peptides on TNF-α secretion from RAW264.7 cells in response to stimulation by CpG-ODN was studied. Each peptide was initially tested at 3 concentrations, 37 μM, 22.2 μM, and 11.1 μM. Seventeen peptides demonstrating inhibition of TNF-α secretion of 50-100% across all three doses are presented (Table 2). The peptides were then tested at 11.1 μM, 7.4 μM, and 3.7 μM (Table 3). The peptides continued to demonstrate inhibitory activity at 7.4 μM, and twelve of the peptides had inhibitory activity at 3.7 μM. Cell viability was examined for each peptide at the concentrations tested for TNF-α inhibition. No decrease in cell viability was demonstrated.

TABLE 2 Percent Inhibition of TNF-α secretion by S1-S22 peptides with a R⁹ sequence (SEQ ID NOs: 42-44; 68-77; 79-81; 83; and 102-106). RAW264.7 cells were plated at 3 × 10⁵ cells/well in 48-well plates. After 24 h the cells were incubated with peptide at various concentrations at room temperature in triplicate for 15 minutes and then stimulated with 1 μg/ml Cpg-ODN. Cells were then incubated for 4 hours at 37° C., supernatants collected, and TNF-α measured by ELISA. Percent inhibition was calculated by comparing TNF-α secretion from cells incubated with peptide to control cells with no peptide treatment. 37 Peptide μM 22.2 μM 11.1 μM Sequence  42(S1)-R⁹  97  96 85 EMFTILEEYFMYRGLLGLRIKYGRLFNEIRRRRRRRRR (SEQ ID NO: 42)  43(S2)-R⁹ 100  94 91 MFTILEEYFMYRGLLGLRIKYGRLFNEIRRRRRRRRR (SEQ ID NO: 43)  44(S3)-R⁹  95  96 91 FTILEEYFMYRGLLGLRIKYGRLFNEIRRRRRRRRR (SEQ ID NO: 44)  68(S4)-R⁹ 100 100 95 EMFTILEEYFMYRGLLGLRIKYGRLFNRRRRRRRRR (SEQ ID NO: 68)  69(S5)-R⁹ 100 100 93 EMFTILEEYFMYRGLLGLRIKYGRLFRRRRRRRRR (SEQ ID NO: 69)  70(S6)-R⁹ 100 100 93 EMFTILEEYFMYRGLLGLRIKYGRLRRRRRRRRR (SEQ ID NO: 70)  71(S7)-R⁹  91  82 56 EMFTILEEYFMYRGLLGLRIKYGRRRRRRRRRR (SEQ ID NO: 71)  72(S8)-R⁹ 100 100 92 EMFTILEEYFMYRGLLGLRIKYGRRRRRRRRR (SEQ ID NO: 72)  73(S9)-R⁹ 100 100 84 EMFTILEEYFMYRGLLGLRIKYRRRRRRRRR (SEQ ID NO: 73)  74(S10)-R⁹ 100 100 91 EMFTILEEYFMYRGLLGLRIKRRRRRRRRR (SEQ ID NO: 74)  75(S11)-R⁹  98  97 92 EMFTILEEYFMYRGLLGLRIRRRRRRRRR (SEQ ID NO: 75)  76(S12)-R⁹  87  84 82 EMFTILEEYFMYRGLLGLRRRRRRRRRR (SEQ ID NO: 76)  77(S13)-R⁹  93  89 84 EMFTILEEYFMYRGLLGLRRRRRRRRR (SEQ ID NO: 77)  79(S14)-R⁹  97  93 85 EMFTILEEYFMYRGLLRRRRRRRRR (SEQ ID NO: 79)   80(S15)-R⁹  91  87 78 EMFTILEEYFMYRGLRRRRRRRRR (SEQ ID NO: 80)  81(S16)-R⁹  90  86 84 EMFTILEEYFMYRGRRRRRRRRR (SEQ ID NO: 81)   83(S17)-R⁹  89  82 72 EMFTILEEYFMYRRRRRRRRR (SEQ ID NO: 83) 102(S18)-R⁹ —  91 72 MFTILEEYFMYRGLLGLRIRRRRRRRRR (SEQ ID NO: 102) 103(S19)-R⁹ —  99 93 FTILEEYFMYRGLLGLRIRRRRRRRRR (SEQ ID NO: 103) 104(S20)-R⁹ —  93 74 TILEEYFMYRGLLGLRIRRRRRRRRR (SEQ ID NO: 104) 105(S21)-R⁹ —  91 62 ILEEYFMYRGLLGLRIRRRRRRRRR (SEQ ID NO: 105) 106(S22)-R⁹ —  92 70 LEEYFMYGLLGLRIRRRRRRRRR (SEQ ID NO: 106)

TABLE 3 Inhibition of TNF-α secretion by S1-S22 peptides with an R⁹ sequence (SEQ ID NOs: 42-44; 68-77; 79-81; 83; and 102-106). RAW264.7 cells were plated at 3 × 10⁵ cells/well in 48-well plates. After 24 h the cells were incubated with peptide at various concentrations at room temperature in triplicate for 15 minutes and  then stimulated with 1 μg/ml Cpg-ODN. Cells were then incubated for 4 hours at 37° C., supernatants collected, and TNF-α measured by ELISA. Percent inhibition was calculated by comparing  TNF-α secretion from cells incubated with peptide to control cells with no peptide treatment. Peptide 11 μM 7 μM 3.1 μM Sequence  42(S1)-R⁹ 83 67 37 EMFTILEEYFMYRGLLGLRIKYGRLFNEIRRRRRRRRR (SEQ ID NO: 42)  43(S2)-R⁹ 70 51  0 MFTILEEYFMYRGLLGLRIKYGRLFNEIRRRRRRRRR (SEQ ID NO: 43)  44(S3)-R⁹ 78 24  0 FTILEEYFMYRGLLGLRIKYGRLFNEIRRRRRRRRR (SEQ ID NO: 44)  68(S4)-R⁹ 95 83 69 EMFTILEEYFMYRGLLGLRIKYGRLFNRRRRRRRRR (SEQ ID NO: 68)  69(S5)-R⁹ 93 94 66 EMFTILEEYFMYRGLLGLRIKYGRLFRRRRRRRRR (SEQ ID NO: 69)  70(S6)-R⁹ 94 87 63 EMFTILEEYFMYRGLLGLRIKYGRLRRRRRRRRR (SEQ ID NO: 70)  71(S7)-R⁹ 38 29 21 EMFTILEEYFMYRGLLGLRIKYGRRRRRRRRRR (SEQ ID NO: 71)  72(S8)-R⁹ 93 80 43 EMFTILEEYFMYRGLLGLRIKYGRRRRRRRRR (SEQ ID NO: 72)  73(S9)-R⁹ 85 76  3 EMFTILEEYFMYRGLLGLRIKYRRRRRRRRR (SEQ ID NO: 73)  74(S10)-R⁹ 92 80 35 EMFTILEEYFMYRGLLGLRIKRRRRRRRRR (SEQ ID NO: 74)  75(S11)-R⁹ 93 84 31 EMFTILEEYFMYRGLLGLRIRRRRRRRRR (SEQ ID NO: 75)  76(S12)-R⁹ 84 67 44 EMFTILEEYFMYRGLLGLRRRRRRRRRR (SEQ ID NO: 76)  77(S13)-R⁹ 81 77 18 EMFTILEEYFMYRGLLGLRRRRRRRRR (SEQ ID NO: 77)  79(S14)-R⁹ 86 77  0 EMFTILEEYFMYRGLLRRRRRRRRR  (SEQ ID NO: 79)  80(S15)-R⁹ 81 68 57 EMFTILEEYFMYRGLRRRRRRRRR  (SEQ ID NO: 80)  81(S16)-R⁹ 70 53 26 EMFTILEEYFMYRGRRRRRRRRR  (SEQ ID NO: 81)  83(S17)-R⁹ 57 44  0 EMFTILEEYFMYRRRRRRRRR  (SEQ ID NO: 83) 102(S18)-R⁹ 72 48 — MFTILEEYFMYRGLLGLRIRRRRRRRRR (SEQ ID NO: 102) 103(S19)-R⁹ 93 87 — FTILEEYFMYRGLLGLRIRRRRRRRRR (SEQ ID NO: 103) 104(S20)-R⁹ 74 60 — TILEEYFMYRGLLGLRIRRRRRRRRR  (SEQ ID NO: 104) 105(S21)-R⁹ 62 52 — ILEEYFMYRGLLGLRIRRRRRRRRR  (SEQ ID NO: 105) 106(S22)-R⁹ 70 53 — LEEYFMYGLLGLRIRRRRRRRRR  (SEQ ID NO: 106)

Example 3 Effect of Peptides on of CpG-ODN-Induced Cytokine Secretion

Inhibition of TNF-α secretion by various T-peptides was examined. RAW264.7 cells were plated at 3×10⁵ cells/well in 48-well plates. After 24 h the cells were incubated with peptide at various concentrations at room temperature in triplicate for 15 minutes and then stimulated with 1.25 ug/ml CpG-ODN or 1 ng/ml LPS. Cells were then incubated for 4 hours at 37° C., supernatants collected, and TNF-α measured by ELISA. Percent inhibition was calculated by comparing TNF-α secretion from cells incubated with peptide to control cells with no peptide treatment. The inhibitive effects of peptides T3 (SEQ ID NO: 319), T11 (SEQ ID NO: 327), T21 (SEQ ID NO: 337), T36 (SEQ ID NO: 352), T37 (SEQ ID NO: 353), T51 (SEQ ID NO: 367), and T52 (SEQ ID NO: 368) were compared to inhibition by an analogue of P13 (SEQ ID NO: 369) having a sequence of nine arginine residues at the C-terminus (P13-R⁹ (SEQ ID NO: 378)). (Table 4).

TABLE 4 Percent Inhibition of TNF-α secretion by T  peptides. Percent inhibition was caluculated by  comparing TNF-α secretion from cells incubated  with peptide to control cells with no peptide  treatment. CpG Stimulation 22 11.1 7.1 Peptide μM μM  μM Sequence P13-R⁹ 86 65 32 DIVKLTVYDCIRRRRRRRRR (SEQ ID NO: 378)  T3-R⁹ 99 92 85 AIVKLTVYDCIRRRRRRRRR (SEQ ID NO: 133) T21-R⁹ 98 90 69 DIVKLYVYDCIRRRRRRRRR (SEQ ID NO: 151) T36-R⁹ 82 70 50 DIIKLTVYDCIRRRRRRRRR (SEQ ID NO: 166) T37-R⁹ 93 87 46 DIVKVTVYDCIRRRRRRRRR (SEQ ID NO: 167) T51-R⁹ 99.7 98 94 AIVKLTVYACIRRRRRRRRR (SEQ ID NO: 181) T52-R⁹ 100 99.2 97.8 AIIKVYVYACIRRRRRRRRR (SEQ ID NO: 182) LPS Stimulation 22.2 11.1 7.4 Peptide uM uM uM Sequence P13-R⁹ 69 13  0 DIVKLTVYDCIRRRRRRRRR (SEQ ID NO: 378)  T3-R⁹ 77 65 33 AIVKLTVYDCIRRRRRRRRR (SEQ ID NO: 133) T11-R⁹ 91 81 68 DIVKLTVYACIRRRRRRRRR (SEQ ID NO: 141)

Example 4 Structure-Activity Testing of Peptides Derived from P13 (SEQ ID NO: 369)

Structure-activity relationships (SAR) were investigated to determine tolerances to residue modification in P13 (SEQ ID NO: 369). Peptides used in the SAR include SEQ ID NOS: 131-182, used to study the activities of SEQ ID NOS: 317-368. Peptides possessing the following structural modifications were made and evaluated for activity vis-à-vis P13 (SEQ ID NO: 369):

1. Deletions of N- and/or C-terminal residues;

2. Alanine scan at each residue;

3. Comparison of residues with like charges at the same position (for example, Asp or Glu at the same position; Lys, Arg, or His at the same position);

4. Comparison of hydroxylated side chains at the same position (for example, Ser or Thr at the same position);

5. Comparison of aromatic side chains at the same position (for example, Phe, Tyr, His, or Trp at the same position);

6. Replacement of side chains with sulfur-containing side chains (for example, Met and Cys);

7. Conservative replacement of branched aliphatic side chains (for example, Leu, Ile, and Val);

8. Disruption of structure by inclusion of alternate residues;

9. Reverse and scrambled sequence; and

10. Dimerization.

The SAR revealed that certain substitutions led to peptides with activity superior to that of P13 (SEQ ID NO: 369). The substitution of a single amino acid, in at least five different cases, and the substitution of two or more amino acids in at least two cases, resulted in superior activity. These seven peptides are SEQ ID NOS: 133, 141, 151, 166, 167, 181, and 182. The discovery was unexpected in that the activity of the SAR derivatives was expected to be comparable or lesser than that of P13 (SEQ ID NO: 369). Activity was defined as inhibition of TNF-α after stimulation of RAW264.7 cells with CpG.

Example 5 Effect of Peptides on Otitis Media

Induction of Otitis Media:

BALB/c (Bagg albino) mice, about 8-12 weeks of age, are anesthetized with a subcutaneous injection of xylazine & ketamine (about 0.1 mg/30 gm body weight) and their ears examined under the operating microscope to assure they are free of infection or perforation. One group of animals is injected with PBS (Phospho-buffered saline) in one ear and with about 10 μM of a peptide of Table 1 in the opposite ear, to determine the effect of peptide without added bacteria. A second group of animals receive about 5.0 μl of PBS plus heat-inactivated S. pneumoniae (about 10⁹ CFU/ml) in one ear and about 5.0 μl of peptide (about 10 μM) plus heat-inactivated S. pneumoniae (about 10⁹ CFU/ml) in the opposite ear. Injections are done through the tympanic membrane. Animals are killed about 3 days after bacterial injection and tissue is histologically processed to assess middle ear disease. Inflammation is quantified by measuring 1) area of fluid present in the middle ear; 2) number of cells in middle ear fluid; and 3) thickness of the tympanic membrane (TM) taken at a point away from the injection site. Data are obtained from mice (n=18) injected with PBS alone for each of the histological parameters measured, to serve as a control group. Disease induction is defined as positive if the ear injected with S. pneumoniae without peptide demonstrated an increase of at least two standard deviations above the control PBS treated mice in at least two of the three parameters assessed for middle ear inflammation: Fluid area, cell number, thickness of the tympanic membrane.

Tissue Collection:

At the end of the experimental treatment, mice are killed and tissues collected for histology. Mice are overdosed on anesthetic and perfused intracardially with about 1.0 mL of saline, followed by about 20 mL of fixative (about 1.5% paraformaldehyde, about 3% glutaraldehyde in about 0.1 M phosphate buffer). The middle ears are left intact and connected to each other by the skull base so both ears are processed together for histology and sectioning. This enables all histologic embedding, sectioning, staining, and analysis to be done on the two sides simultaneously to reduce any impact of processing variables on the subsequent quantitative analyses. Middle ears are decalcified, embedded in glycol methacrylate plastic, sectioned at about 5 μm, mounted serially on glass slides, stained, and coverslipped.

Histopathologic Analysis:

Three consecutive sections at the level of the umbo and promontory are selected for measures of 1) area of fluid present in the middle ear; 2) number of cells in middle ear fluid; and 3) thickness of the tympanic membrane. Each measurement is taken on the three sequential sections per specimen.

Statistical Analyses:

To determine the effect of peptide without added bacteria, animals are injected in one ear with PBS alone, and the other ear with about 10 μM peptide. Paired t-tests are done comparing the effect of PBS alone with the effect of peptide for each of the three histological parameters: 1) area of fluid present in the middle ear; 2) number of cells in middle ear fluid; and 3) thickness of the tympanic membrane. Paired t-tests are done using these animals comparing the effect of peptide plus S. pneumoniae in one ear with S. pneumoniae alone in the opposite ear for each of the histological parameters described above.

Example 6 Effect of Peptides on Septic Shock

Inhibition of Inflammatory Mediators in a Murine Septic Shock Model.

BALB/c mice are injected i.p. with PBS, LPS at about 100 μg/mouse/250 μl, or about 100 μg LPS plus various doses of peptides. Serum is collected at about 2 and about 6 hours after treatment and evaluated for the pro-inflammatory cytokines MIP-2 and TNF-α by ELISA, and for soluble ICAM-1.

Example 7 Effects of P13 (SEQ ID NO: 369) on Mouse Middle Ear

Assay of Effects Caused by Peptide without Added Bacteria.

Five mice were injected in one ear with PBS and in the opposite ear with 10 μM peptide P13 (SEQ ID NO: 369). Three days later the animals were killed, and the middle ears embedded, sectioned, stained and evaluated for fluid area, infiltrating cell number, and thickness of the tympanic membrane. Paired t-tests (2-tailed) were used to analyze each of the three parameters. In the absence of bacterial-induced inflammation, no differences were seen between the PBS-injected ear and P13-injected ear in 1) fluid area (p=0.104); 2) cell number (p=0.880); or 3) tympanic membrane thickness (p=0.891).

Assay of Effects Caused by Peptide with Added Bacteria.

To examine the effectiveness of the peptide to affect inflammation in vivo, twenty BALB/c mice were injected in the middle ear on one side with heat-inactivated S. pneumoniae plus PBS, and in the middle ear on the opposite side with heat-inactivated S. pneumoniae plus 10 μM peptide P13 (SEQ ID NO: 369). Three days later the animals were killed, and evaluated for middle ear fluid area, infiltrating cell number, and thickness of the tympanic membrane. Disease development was defined as an increase over background controls (PBS injected ears n=18) of at least two standard deviations in two out of the three parameters quantified. A total of 7 out of 20 mice met the criteria for disease induction. Analysis of middle ears by paired t-tests from these 7 mice with disease showed that peptide treatment significantly reduced the amount of fluid (p=0.004), infiltrating cell number (p=0.02), and thickness of the tympanic membrane (p=0.002). Examination of these three parameters of inflammation for each individual mouse with disease illustrated the dramatic effect seen with a single treatment of peptide P13 (SEQ ID NO: 369). Of interest, 6 of the 7 mice demonstrated reductions in all areas of inflammation, while one animal showed only modest reduction in fluid area and tympanic membrane thickness, and no reduction in cell number. Injection of heat-killed bacteria resulted in a marked inflammatory response in the middle ear after 3 days. This was characterized by mucosal and tympanic membrane swelling, cellular infiltration, and significant fluid (effusion) secretion and accumulation that filled the middle ear space. The inflammatory response led to significant mucosal cellular hypertrophy and active secretion of mucins and other fluids. When peptide P13 (SEQ ID NO: 369) was injected with the bacteria, a significant reduction was seen in fluid accumulation into the middle ear space and reduced mucosal hypertrophy.

TABLE 5 Peptide Inhibition of Middle Ear Inflammation^(a) Tympanic Membrane Fluid Area Cell Number Thickness Treatment (microns² ± S.D.) (±S.D.) (microns ± S.D.) PBS^(b) 1016 ± 1397 31 ± 41 44 ± 20 S. pneumoniae ^(c) 5771 ± 2077 252 ± 140 105 ± 33  S. pneumoniae + 1486 ± 1192 111 ± 119 44 ± 15 peptide^(c) p value (2-tailed)^(d) p = 0.004 p = 0.020 p = 0.002 ^(a)Middle ear inflammation is assessed by measuring three consecutive tissue sections for area of fluid in the middle ear, number of cells in the middle ear fluid, and thickness of the tympanic membrane measured at a point away from the injection site. Data represent the mean ± SD animals with middle ear inflammation. Statistical evaluation is done using a paired t-test. ^(b)The PBS treated animals receive no bacteria or peptides. ^(c)Animals are injected in one ear with S. pneumoniae + PBS and in the opposite ear with S. pneumoniae + peptide (about 10 μM). ^(d)Statistical evaluation using a paired t-test is done using data collected from diseased animals injected with bacteria and comparing peptide vs. no peptide treatment.

Example 8 Assay for Crossing the Tympanic Membrane by FITC-Labeled P13-R⁹ (SEQ ID NO: 378)

BALB/c mice were injected through the bulla by the following protocol.

Three BALB/c mice at 8-12 weeks of age were anesthetized with ketamine (100 mg/kg) and xylazine (20 mg/kg) prior to administration of bacteria. A ventral midline incision was made in the neck, and the bulla exposed after blunt dissection. The middle ear was inoculated through the bony wall with approximately 3.5 μL of a bacterial suspension (heat inactivated S. pneumoniae 10¹⁰ CFU/ml) with a thin needle. Both the right and left ears received bacteria by bulla injection.

After 24 hours, animals received an otoscopic exam using an operating microscope. Mice were anesthetized as described above, and the tympanic membrane was inspected for the presence or absence of the following three criteria for acute otitis media (AOM): 1) middle ear effusion behind the tympanic membrane; 2) change in color of the tympanic membrane from clear to red or white (indicating inflammation and/or purulence in the middle ear); and 3) change in position of the tympanic membrane from neutral to bulging or retracted. Only animals demonstrating AOM by these criteria were used.

Four ears met the criteria for AOM. FITC labeled peptide P13-R⁹ (SEQ ID NO: 378) (10 μg/30 μl) was dropped onto the middle ear. The peptide was allowed to absorb for 10 minutes. After 10 minutes, the external ear canal was flushed twice, and blotted to get rid of any remaining peptide. The middle ear fluid was then aspirated with a 10 μL Hamilton syringe with a 30 g needle, and the fluid smeared on a slide. FITC-labeled peptide was viewed under a fluorescent scope. The photograph demonstrates that FITC-labeled P13-R⁹ (SEQ ID NO: 378) crosses the tympanic membrane and associates with cells in middle ear fluid.

FIG. 1A illustrates bright field microscopy of cells in middle ear fluid. FIG. 1B illustrates fluorescent microscopy of FITC-labeled P13-R⁹ (SEQ ID NO: 378) associated with cells in middle ear fluid.

Example 9 Topical Administration of P13 (SEQ ID NO: 369) Reduced Middle Ear Inflammation and Fluid Retention

In this experiment, P13 (SEQ ID NO: 369) was administered by ear drops to reduce inflammation and fluid retention in the pre-clinical AOM model. BALB/c mice (n=13) received an otoscopic exam using an operating microscope to establish the clinical symptoms of AOM. Mice were anesthetized and the tympanic membrane (TM) inspected for presence or absence of the following 3 criteria for AOM: 1) middle ear effusion behind the TM; 2) change in color of the TM from clear to red or white, indicating inflammation and/or purulence in the middle ear; and 3) change in position of the TM from neutral to bulging or retracted. An animal exhibiting any of these changes was scored positive for inflammation. All mice scored negative on pre-screen and were injected transtympanically with 5 μL heat inactivated S. pneumonia (10⁹ CFU/mL) in both ears. Twenty-four hours post bacterial injection, mice were examined by otoscopic exam and those animals meeting the inflammation criteria described above remained in the study. Of the thirteen ears scored as positive; seven ears were treated topically with P13 (SEQ ID NO: 369) (1 μg/30 μL), and six ears treated topically with PBS (30 μL). For topical treatment, animals were lightly anesthetized and P13 (SEQ ID NO: 369) or PBS was dropped onto the external tympanic membrane. The animals remained sedated for 15-20 minutes. Seventy-two hours post bacterial injection, animals were sacrificed and tissue histologically processed to assess middle ear disease. Inflammation was quantified by measuring the area of fluid present in the middle ear and number of cells in the measured middle ear fluid area as follows. Mice were overdosed on anesthetic and perfused intracardially with 1.0 mL of saline, followed by 20 mL of fixative (1.5% paraformaldehyde-3% glutaraldehyde in 0.1 M phosphate buffer). Middle ears were decalcified, embedded in glycol methacrylate plastic, sectioned at 5 μm, mounted serially on glass slides stained, and cover-slipped. Three consecutive sections at the level of the umbo and promontory were selected for measures of 1) area of fluid present in the middle ear; and 2) number of cells in middle ear fluid. Each measurement was taken on the three sequential sections per specimen. The value presented for each parameter represents the mean of the three sections (FIG. 2). This experiment confirmed that ear drop administration of P13 (SEQ ID NO: 369) dramatically reduced both the cellular infiltration and residual fluid in the pre-clinical AOM model. Of interest, the one animal in the P13 (SEQ ID NO: 369) treatment group showing high cell number and high fluid area is the same animal.

Example 10 Topical Administration of P13 (SEQ ID NO: 369) Significantly Reduced the Severity and Longevity of Hearing Impairment A. Topical Administration of P13 (SEQ ID NO: 369) Demonstrated Efficacy in a Mouse Model of AOM.

Patients with AOM frequently experience residual middle ear fluid retention which can lead to impaired hearing, recurrent infections, and in extreme conditions the need for surgical placement of ear tubes. To determine whether topical administration of P13 (SEQ ID NO: 369) would impact hearing in a pre-clinical model of AOM, BALB/c mice (n=8), 13 weeks of age, received a baseline auditory brainstem response (ABR) and otoscopic exam in both ears. ABR stimuli consisted of 20 tone-burst trains at 4 kHz, 8 kHz, 16 kHz and 32 kHz at five intensity levels in 10 dB steps. Each tone-burst had a two-ms duration, with tone burst onsets separated by 12 ms. Two separate trains offset by 5 dB were presented as stimuli, then combined in data analysis to determine threshold in 5 dB steps. Responses to 300 stimulus repetitions were averaged using a digital oscilloscope. Thresholds were based on the lowest intensity at which a response could be identified. The number of waves present at threshold varied somewhat, but the presence of at least two waves was considered a valid threshold. An otoscopic exam was performed using an operating microscope to establish the clinical symptoms of AOM, as previously described. All 8 animals remained in the study and were injected transtympanically with 5 μL heat inactivated S. pneumonia (10⁹ CFU/mL) in both ears. Twenty-four hours post bacterial injection, mice were examined by otoscopic exam and those animals meeting the inflammation criteria remained in this study. After 24 hours, each animal was treated topically with P13 (SEQ ID NO: 369) (1 μg/30 μL) in one ear, and PBS (30 uL) in the other. For topical treatment, animals were lightly anesthetized and P13 (SEQ ID NO: 369) or PBS dropped onto the external tympanic membrane. The animals remained sedated for 15-20 minutes.

Five and 13 days after bacterial injection, all animals received ABR testing as described above. ABR data was calculated by subtracting the baseline ABR from the post-bacterial ABR for each frequency, and then summing all 4 frequencies (4, 8, 16 and 32 kHz). A two-way repeated measure ANOVA was done for data analysis using days 5 and 13. This experiment confirmed that ear drop administration of P13 (SEQ ID NO: 369) significantly limited the hearing impairment seen in control treated animals. Treatment with P13 (SEQ ID NO: 369) reduced the severity of hearing impairment and reduced the time to resolution to normal baseline hearing levels (FIG. 3A). P13 (SEQ ID NO: 369) treatment dramatically reduced the number of animals with hearing loss as compared to PBS treatment (FIG. 3B). In summary, these data confirmed the efficacy of P13 (SEQ ID NO: 369) in reducing the severity and longevity of hearing impairment.

B. Topical Administration of P13 (SEQ ID NO: 369) Demonstrated Efficacy in a Mouse Model of Chronic Otitis Media.

Eight C3H/HeJ mice (12 months of age) were given a clinical ear examination. Those animals demonstrating middle ear inflammation (6 mice) were given two baseline ABRs, one week apart, and then each ear was treated topically with either PBS, or 1 μg P13 (SEQ ID NO: 369). One and two weeks after P13 (SEQ ID NO: 369)/PBS treatment, animals again received an otoscopic exam and an ABR assessment. ABR data were calculated by subtracting the baseline ABR from the post-treatment ABR for each frequency, and then summing all 4 frequencies. Topical P13 (SEQ ID NO: 369) treatment resulted in a statistically significant improvement in hearing thresholds as assessed by ABR measurements across all four frequencies at both weeks 1 and 2 post-treatment. This data showed a dramatic improvement in hearing thresholds at both time-points, with an approximate 40 db improvement at week 2. An examination of a single frequency (4 kHz) demonstrated the impact of P13 (SEQ ID NO: 369) treatment on hearing, where at week 2 post-treatment, there was an approximate 12 db hearing improvement in P13 (SEQ ID NO: 369) treated animals as compared to controls. No change was observed in the middle ear inflammatory status as assessed by otoscopic exam after peptide treatment at either time point.

C. Comparison of the D- and L-Isomer Forms of P13 (SEQ ID NO: 369) in Treating COM.

The biological half-life of peptides can be improved by using the D-isomer of amino acid residues in place of the L-isomer form. A stereoisomer of P13 (SEQ ID NO: 369) containing all D-amino acid residues (D-P13) was therefore tested for efficacy in treating C3H/HeJ mice with COM, and the results were compared to those obtained with the stereoisomer containing all L-amino acid residues (L-P13). The D-P13 peptide was produced by standard methods and was purified to >95%. Three C3H/HeJ mice with COM were treated topically with D-P13 in both ears as described above and ABRs assessed at weeks 1 and 2 post-treatment. Similar to what was seen with L-P13 treatment, treatment with D-P13 also demonstrated efficacy in improving hearing thresholds in COM mice with clinically documented disease. At week 2 post-treatment, D-P13 improved hearing thresholds across all frequencies approximately 20 db as compared to an approximate 40 db improvement after treatment with L-P13. While the L-isomer of P13 (SEQ ID NO: 369) showed a more pronounced improvement of hearing thresholds, the D- and L-isomer forms of P13 (SEQ ID NO: 369) exhibited similar levels of statistical confidence in this experiment.

Example 11 Topical Administration of P13 (SEQ ID NO: 369) Lacked Ototoxicity

P13 (SEQ ID NO: 369) was investigated for possible negative impact on hearing in normal mice upon administration by ear drops. BALB/c mice, 16 weeks of age, (n=16) received two baseline auditory brainstem response (ABR) tests one week apart, and an otoscopic exam in both ears. ABR stimuli consisted of 20 tone-burst trains at 4 kHz, 8 kHz, 16 kHz and 32 kHz at five intensity levels in 10 dB steps, as previously described. An otoscopic exam was performed using an operating microscope to establish the clinical symptoms of AOM, as previously described. Any animal with an abnormal ABR or exam on pre-screen was not entered into the study.

All 16 animals remained in the study and were divided into five groups as follows:

group 1: (n=6 ears) 1 μg P13 (SEQ ID NO: 369)/30 μl, topically, given once;

group 2: (n=7 ears) 10 μg P13 (SEQ ID NO: 369)/30 μL, topically, given once;

group 3: (n=7 ears) 10 μg P13 (SEQ ID NO: 369)/30 μL, topically, given twice, 24 hours apart;

group 4: (n=6 ears) 60 μg P13 (SEQ ID NO: 369)/30 μL, topically, given once; and

group 5: (n=6 ears) untreated mice.

ABRs were performed at one, two, three and four weeks post P13 (SEQ ID NO: 369) treatment. The two baseline ABRs were averaged and compared to the ABRs post P13 (SEQ ID NO: 369) treatment. This experiment demonstrated that topical administration of P13 (SEQ ID NO: 369) did not negatively impact hearing thresholds in these normal mice.

Example 12 Evaluation of TNF-α Secretion in Mice Treated with Peptides

The effect of several peptides on TNF-α secretion in mice in response to stimulation by CpG-ODN and LPS is studied. Peptide compositions are prepared for each peptide-R⁹, at 3 concentrations, 37 μM, 22.2 μM, and 11.1 μM, and tested. Peptides demonstrating activity in this assay are further formulated into peptide compositions at 11.1 μM, 7.4 μM, and 3.7 μM for re-assay.

BALB/c (Bagg albino) mice, about 8-12 weeks of age, are anesthetized with a subcutaneous injection of xylazine & ketamine (about 0.1 mg/30 gm body weight). The mice are injected in both ears with either 1.25 ug/ml CpG-ODN or 1 ng/ml LPS. Twenty-four hours later the mice are treated topically (ear drop) with 1 μg peptide/30 μl in one ear and PBS (30 μl) in the other. Twenty-four hours post peptide/PBS treatment, middle ear fluid is collected and analyzed for TNF-α secretion by ELISA. Ears exhibiting lesser TNF-α secretion than the control ears identify peptides that effectively inhibit TNF-α secretion in the live mouse.

Example 13 Effects of Peptides on Mice with Noise-Induced Hearing Loss

Mice (CBA/CaJ) received baseline Auditory Brainstem Response (ABR) testing followed by treatment and noise exposure. ABR testing was done immediately following; 24 hours; 48 hours; one week; and two weeks, following noise exposure. Peptide and control peptide (1 μg) were administered topically by drops placed on the tympanic membrane.

Four treatment groups were used: A) peptide/control treatment both pre- and post-noise exposure; B) peptide/control treatment pre-noise exposure; C) peptide/control treatment post-noise exposure; and D) peptide/control treatment multiple dosing post-noise exposure.

Hearing Thresholds:

ABR audiometry to pure tones was used to evaluate cochlear function. Mice were anesthetized and the individual ears of each mouse were stimulated with a closed tube sound delivery system sealed into the ear canal. The ABR to tone-burst stimuli at 4, 8, 16, and 32 kHz were recorded and thresholds obtained for each ear.

Peptide Treatment:

Animals were lightly anesthetized and peptide or control dropped onto the external tympanic membrane. The animals remained sedated for 15-20 minutes.

Noise Exposure:

Mice were exposed to broad band noise at 100 dB(A) SPL for 2 hrs/day. ABRs were performed immediately post-noise exposure and hearing thresholds quantified at both 16 and 32 kHz and subtracted from pre-noise exposure ABR thresholds.

Results:

Ears treated with P13 (SEQ ID NO: 369) suffered substantially-less hearing loss than did ears treated with the control peptide, as illustrated in FIG. 5.

Example 14 P13 (SEQ ID NO: 369) and P7 (SEQ ID NO: 379) Inhibit TNF-α-Stimulated by Danger Signals from Necrotic Cell Extracts

Acoustical trauma can cause necrotic cell death, which is associated with the release of danger signals that can stimulate the immune system through toll-like receptors. The inflammatory response can contribute substantially to the damage from the initial injury and exacerbate noise-induced hearing loss.

P13 (SEQ ID NO: 369) and P7 (SEQ ID NO: 379) demonstrated in vitro inhibition of TNF-α when cells were stimulated with NCE. NCE was prepared from RAW 264.7 cells by multiple freeze/thaws. A fresh colony of RAW264.7 cells was incubated with P13 (SEQ ID NO: 369), P7 (SEQ ID NO: 379), or a control peptide (30 μg/mL) for 15 minutes and then stimulated with NCE. After 4 hours, supernatants were collected and assayed for TNF-α by ELISA. Multiple experiments were performed, and the TNF-α production in cells incubated with peptide was compared to cells without peptide, as illustrated in FIG. 6. Both P13 (SEQ ID NO: 369) and P7 (SEQ ID NO: 379) significantly inhibited NCE-stimulated TNF-α production as compared to the control peptide. As a control, the NCE was also examined alone (no cells) for TNF-α content, which was negligible (data not shown).

The abilities of P13 (SEQ ID NO: 369) and P7 (SEQ ID NO: 379) to inhibit NCE-stimulated TNF-α production indicated that P13 (SEQ ID NO: 369) and P7 (SEQ ID NO: 379) can suppress TLR-induced inflammation in necrotic tissue, such as noise-damaged tissue associated with noise-induced hearing loss.

Example 15 Topical Administration of P13 (SEQ ID NO: 369) Delays Onset of Age-Related Hearing Loss

C57Bl/6 mice develop age-related hearing loss. The progressive hearing loss begins at about 1 to 2 months with a loss in the highest spectral frequencies, which increases in severity and spreads to lower frequencies over the next 12 to 15 months. The induction of a Bak-dependent mitochondrial apoptosis program in response to oxidative stress is a mechanism of age-related hearing loss in these mice.

C57Bl/6 mice (n=10) received baseline ABRs at 12 weeks and were treated with P13 (SEQ ID NO: 369) in one ear while the contralateral ear remained untreated. P13 (SEQ ID NO: 369) delayed hearing loss in all four frequencies tested in 50% (n=5) of the mice. The 5 mice with positive effects are represented in FIG. 7 to demonstrate the magnitude and timing of hearing loss delay. Hearing thresholds at 32, 16, 8 and 4 kHz are shown. Treatment schedule for P13 (SEQ ID NO: 369), administered topically as ear drops, is shown in FIG. 7 a, with hash marks indicating incidents of administration.

Example 16 P13 (SEQ ID NO: 369) Improves Hearing Levels in Normal BALB/c Mice

In a six-week study, normal BALB/c mice were treated topically (ear drops) with 1 μg P13 (SEQ ID NO: 369) at weeks 0 and 5. Hearing thresholds were quantified by ABRs at 4, 8, 16, and 32 kHz over a six week period. Hearing improvement was calculated by subtracting post-treatment ABR from the background ABR and summing across frequencies. The results are illustrated in FIG. 8.

Administration of P13 (SEQ ID NO: 369) to an ear resulted in rapid improvement in hearing, which was sustained for about two to about three weeks, whereupon the hearing quality returned to the native level. Re-administration of P13 (SEQ ID NO: 369) to the same ear resulted in hearing improvement similar to what had been observed upon initial administration.

EMBODIMENTS

The following non-limiting embodiments provide representative examples of the invention, but do not limit the scope of the invention.

The following Embodiments describe methods of treating noise-induced hearing loss.

Embodiment 1

A method of treating noise-induced hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of Formula (I) or Formula (II) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof, wherein the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

Embodiment 2

The method of Embodiment 1, wherein the peptide is a peptide of Formula (I).

Embodiment 3

The method of any one of Embodiments 1 and 2, wherein X¹ is A, D, E, K or is absent; X⁴ is A, E, H, I, K, R, or Y; X⁸ is A, F, P, S, T, W, or Y; and X⁹ is A, D, E, or K.

Embodiment 4

The method of any one of Embodiments 1-3, wherein cap^(N) is H and cap^(C) is OH.

Embodiment 5

The method of any one of Embodiments 1-4, wherein at least one amino acid residue of the peptide possesses the D-configuration.

Embodiment 6

The method of any one of Embodiments 1-5, wherein at least one of amino acid residues X¹⁻¹¹ possesses the D-configuration.

Embodiment 7

The method of any one of Embodiments 1-6, wherein pep^(N), pep^(C), and tran^(N) are absent, and tran^(C) is a transducing sequence.

Embodiment 8

The method of any one of Embodiments 1-7, wherein the transducing sequence is a poly-arginine sequence.

Embodiment 9

The method of Embodiment 8, wherein the poly-arginine sequence consists of about nine arginine residues.

Embodiment 10

The method of any one of Embodiments 8 and 9, wherein at least one arginine residue of the poly-arginine sequence possesses the D-configuration.

Embodiment 11

The method of any one of Embodiments 8-10, wherein each residue of the poly-arginine sequence possesses the D-configuration.

Embodiment 12

The method of any one of Embodiments 1-11, wherein the peptide is administered orally, topically, intraaurally, parenterally, intravenously, intra-arterially, subcutaneously, intramuscularly, intracranially, or intranasally.

Embodiment 13

The method of any one of Embodiments 1-12, wherein the peptide is administered topically.

Embodiment 14

The method of any one of Embodiments 1-13, wherein the peptide is administered to the skin, hair, outer ear, tympanic membrane, buccal cavity, nasal cavity, or sublingual cavity.

Embodiment 15

The method of any one of Embodiments 1-14, wherein the peptide is administered to the tympanic membrane.

Embodiment 16

The method of any one of Embodiments 1-15, wherein the peptide is administered in the form of a drop.

Embodiment 17

The method of any one of Embodiments 1-17, wherein the subject is a human.

Embodiment 18

The method of any one of Embodiments 1-18, wherein the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; and 363-368.

Embodiment 19

A method of treating noise-induced hearing loss, the method comprising administering a therapeutically-effective amount of a peptide to a subject in need or want thereof, wherein the peptide comprises: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing, wherein the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

Embodiment 20

The method of Embodiment 19, wherein the peptide comprises: IGLCA (SEQ ID NO: 207).

Embodiment 21

The method of Embodiment 19, wherein the peptide comprises: YIKVQ (SEQ ID NO: 227).

Embodiment 22

The method of Embodiment 19, wherein the peptide comprises: LFNEI (SEQ ID NO: 252).

Embodiment 23

The method of Embodiment 19, wherein the peptide comprises: EMFTI (SEQ ID NO: 276).

Embodiment 24

The method of Embodiment 19, wherein the peptide comprises: YRGLL (SEQ ID NO: 287).

Embodiment 25

The method of Embodiment 19, wherein the peptide comprises: RIKYG (SEQ ID NO: 304).

Embodiment 26

The method of Embodiment 19, wherein the peptide comprises: EEYFM (SEQ ID NO: 305).

Embodiment 27

The method of any one of Embodiments 19-26, wherein the peptide further comprises a transducing sequence.

Embodiment 28

The method of Embodiment 27, wherein the transducing sequence is positioned at the C-terminus of the peptide.

Embodiment 29

The method of any one of Embodiments 27 and 28, wherein the transducing sequence is a poly-arginine sequence.

Embodiment 30

The method of Embodiment 29, wherein the poly-arginine sequence consists of about nine arginine residues.

Embodiment 31

The method of any one of Embodiments 19-30, wherein at least one amino acid residue of the peptide possesses the D-configuration.

Embodiment 32

The method of any one of Embodiments 29 and 30, wherein at least one arginine residue of the poly-arginine sequence possesses the D-configuration.

Embodiment 33

The method of any one of Embodiments 29, 30, and 32, wherein each residue of the poly-arginine sequence possesses the D-configuration.

Embodiment 34

The method of any one of Embodiments 19-33, wherein the peptide is administered orally, topically, intraaurally, parenterally, intravenously, intra-arterially, subcutaneously, intramuscularly, intracranially, or intranasally.

Embodiment 35

The method of any one of Embodiments 19-34, wherein the peptide is administered topically.

Embodiment 36

The method of any one of Embodiments 19-35, wherein the peptide is administered to the skin, hair, outer ear, tympanic membrane, buccal cavity, nasal cavity, or sublingual cavity.

Embodiment 37

The method of any one of Embodiments 19-36, wherein the peptide is administered to the tympanic membrane.

Embodiment 38

The method of any one of Embodiments 19-37, wherein the peptide is administered in the form of a drop.

Embodiment 39

The method of any one of Embodiments 19-38, wherein the subject is a human.

Embodiment 40

The method of any one of Embodiments 19-39, wherein the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; and 381-396.

The following Embodiments describe methods of treating age-related hearing loss.

Embodiment 1

A method of treating age-related hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of Formula (I) or Formula (II) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof, wherein the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

Embodiment 2

The method of Embodiment 1, wherein the peptide is a peptide of Formula (I).

Embodiment 3

The method of any one of Embodiments 1 and 2, wherein X¹ is A, D, E, K or is absent; X⁴ is A, E, H, I, K, R, or Y; X⁸ is A, F, P, S, T, W, or Y; and X⁹ is A, D, E, or K.

Embodiment 4

The method of any one of Embodiments 1-3, wherein cap^(N) is H and cap^(C) is OH.

Embodiment 5

The method of any one of Embodiments 1-4, wherein at least one amino acid residue of the peptide possesses the D-configuration.

Embodiment 6

The method of any one of Embodiments 1-5, wherein at least one of amino acid residues X¹⁻¹¹ possesses the D-configuration.

Embodiment 7

The method of any one of Embodiments 1-6, wherein pep^(N), pep^(C), and tran^(N) are absent, and tran^(C) is a transducing sequence.

Embodiment 8

The method of any one of Embodiments 1-7, wherein the transducing sequence is a poly-arginine sequence.

Embodiment 9

The method of Embodiment 8, wherein the poly-arginine sequence consists of about nine arginine residues.

Embodiment 10

The method of any one of Embodiments 8 and 9, wherein at least one arginine residue of the poly-arginine sequence possesses the D-configuration.

Embodiment 11

The method of any one of Embodiments 8-10, wherein each residue of the poly-arginine sequence possesses the D-configuration.

Embodiment 12

The method of any one of Embodiments 1-11, wherein the peptide is administered orally, topically, intraaurally, parenterally, intravenously, intra-arterially, subcutaneously, intramuscularly, intracranially, or intranasally.

Embodiment 13

The method of any one of Embodiments 1-12, wherein the peptide is administered topically.

Embodiment 14

The method of any one of Embodiments 1-13, wherein the peptide is administered to the skin, hair, outer ear, tympanic membrane, buccal cavity, nasal cavity, or sublingual cavity.

Embodiment 15

The method of any one of Embodiments 1-14, wherein the peptide is administered to the tympanic membrane.

Embodiment 16

The method of any one of Embodiments 1-15, wherein the peptide is administered in the form of a drop.

Embodiment 17

The method of any one of Embodiments 1-17, wherein the subject is a human.

Embodiment 18

The method of any one of Embodiments 1-18, wherein the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; and 363-368.

Embodiment 19

A method of treating age-related hearing loss, the method comprising administering a therapeutically-effective amount of a peptide to a subject in need or want thereof, wherein the peptide comprises: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing, wherein the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

Embodiment 20

The method of Embodiment 19, wherein the peptide comprises: IGLCA (SEQ ID NO: 207).

Embodiment 21

The method of Embodiment 19, wherein the peptide comprises: YIKVQ (SEQ ID NO: 227).

Embodiment 22

The method of Embodiment 19, wherein the peptide comprises: LFNEI (SEQ ID NO: 252).

Embodiment 23

The method of Embodiment 19, wherein the peptide comprises: EMFTI (SEQ ID NO: 276).

Embodiment 24

The method of Embodiment 19, wherein the peptide comprises: YRGLL (SEQ ID NO: 287).

Embodiment 25

The method of Embodiment 19, wherein the peptide comprises: RIKYG (SEQ ID NO: 304).

Embodiment 26

The method of Embodiment 19, wherein the peptide comprises: EEYFM (SEQ ID NO: 305).

Embodiment 27

The method of any one of Embodiments 19-26, wherein the peptide further comprises a transducing sequence.

Embodiment 28

The method of Embodiment 27, wherein the transducing sequence is positioned at the C-terminus of the peptide.

Embodiment 29

The method of any one of Embodiments 27 and 28, wherein the transducing sequence is a poly-arginine sequence.

Embodiment 30

The method of Embodiment 29, wherein the poly-arginine sequence consists of about nine arginine residues.

Embodiment 31

The method of any one of Embodiments 19-30, wherein at least one amino acid residue of the peptide possesses the D-configuration.

Embodiment 32

The method of any one of Embodiments 29 and 30, wherein at least one arginine residue of the poly-arginine sequence possesses the D-configuration.

Embodiment 33

The method of any one of Embodiments 29, 30, and 32, wherein each residue of the poly-arginine sequence possesses the D-configuration.

Embodiment 34

The method of any one of Embodiments 19-33, wherein the peptide is administered orally, topically, intraaurally, parenterally, intravenously, intra-arterially, subcutaneously, intramuscularly, intracranially, or intranasally.

Embodiment 35

The method of any one of Embodiments 19-34, wherein the peptide is administered topically.

Embodiment 36

The method of any one of Embodiments 19-35, wherein the peptide is administered to the skin, hair, outer ear, tympanic membrane, buccal cavity, nasal cavity, or sublingual cavity.

Embodiment 37

The method of any one of Embodiments 19-36, wherein the peptide is administered to the tympanic membrane.

Embodiment 38

The method of any one of Embodiments 19-37, wherein the peptide is administered in the form of a drop.

Embodiment 39

The method of any one of Embodiments 19-38, wherein the subject is a human.

Embodiment 40

The method of any one of Embodiments 19-39, wherein the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; and 381-396.

The following Embodiments describe methods of improving hearing.

Embodiment 1

A method of improving hearing, the method comprising administering a therapeutically-effective amount of a peptide of Formula (I) or Formula (II) to a subject in need or want thereof,

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof, wherein the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

Embodiment 2

The method of Embodiment 1, wherein the peptide is a peptide of Formula (I).

Embodiment 3

The method of any one of Embodiments 1 and 2, wherein X¹ is A, D, E, K or is absent; X⁴ is A, E, H, I, K, R, or Y; X⁸ is A, F, P, S, T, W, or Y; and X⁹ is A, D, E, or K.

Embodiment 4

The method of any one of Embodiments 1-3, wherein cap^(N) is H and cap^(C) is OH.

Embodiment 5

The method of any one of Embodiments 1-4, wherein at least one amino acid residue of the peptide possesses the D-configuration.

Embodiment 6

The method of any one of Embodiments 1-5, wherein at least one of amino acid residues X¹⁻¹¹ possesses the D-configuration.

Embodiment 7

The method of any one of Embodiments 1-6, wherein pep^(N), pep^(C), and tran^(N) are absent, and tran^(C) is a transducing sequence.

Embodiment 8

The method of any one of Embodiments 1-7, wherein the transducing sequence is a poly-arginine sequence.

Embodiment 9

The method of Embodiment 8, wherein the poly-arginine sequence consists of about nine arginine residues.

Embodiment 10

The method of any one of Embodiments 8 and 9, wherein at least one arginine residue of the poly-arginine sequence possesses the D-configuration.

Embodiment 11

The method of any one of Embodiments 8-10, wherein each residue of the poly-arginine sequence possesses the D-configuration.

Embodiment 12

The method of any one of Embodiments 1-11, wherein the peptide is administered orally, topically, intraaurally, parenterally, intravenously, intra-arterially, subcutaneously, intramuscularly, intracranially, or intranasally.

Embodiment 13

The method of any one of Embodiments 1-12, wherein the peptide is administered topically.

Embodiment 14

The method of any one of Embodiments 1-13, wherein the peptide is administered to the skin, hair, outer ear, tympanic membrane, buccal cavity, nasal cavity, or sublingual cavity.

Embodiment 15

The method of any one of Embodiments 1-14, wherein the peptide is administered to the tympanic membrane.

Embodiment 16

The method of any one of Embodiments 1-15, wherein the peptide is administered in the form of a drop.

Embodiment 17

The method of any one of Embodiments 1-17, wherein the subject is a human.

Embodiment 18

The method of any one of Embodiments 1-18, wherein the peptide is a peptide of any one of SEQ ID NOS: 131-175; 177-186; 317-361; and 363-368.

Embodiment 19

A method of improving hearing, the method comprising administering a therapeutically-effective amount of a peptide to a subject in need or want thereof, wherein the peptide comprises: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing, wherein the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

Embodiment 20

The method of Embodiment 19, wherein the peptide comprises: IGLCA (SEQ ID NO: 207).

Embodiment 21

The method of Embodiment 19, wherein the peptide comprises: YIKVQ (SEQ ID NO: 227).

Embodiment 22

The method of Embodiment 19, wherein the peptide comprises: LFNEI (SEQ ID NO: 252).

Embodiment 23

The method of Embodiment 19, wherein the peptide comprises: EMFTI (SEQ ID NO: 276).

Embodiment 24

The method of Embodiment 19, wherein the peptide comprises: YRGLL (SEQ ID NO: 287).

Embodiment 25

The method of Embodiment 19, wherein the peptide comprises: RIKYG (SEQ ID NO: 304).

Embodiment 26

The method of Embodiment 19, wherein the peptide comprises: EEYFM (SEQ ID NO: 305).

Embodiment 27

The method of any one of Embodiments 19-26, wherein the peptide further comprises a transducing sequence.

Embodiment 28

The method of Embodiment 27, wherein the transducing sequence is positioned at the C-terminus of the peptide.

Embodiment 29

The method of any one of Embodiments 27 and 28, wherein the transducing sequence is a poly-arginine sequence.

Embodiment 30

The method of Embodiment 29, wherein the poly-arginine sequence consists of about nine arginine residues.

Embodiment 31

The method of any one of Embodiments 19-30, wherein at least one amino acid residue of the peptide possesses the D-configuration.

Embodiment 32

The method of any one of Embodiments 29 and 30, wherein at least one arginine residue of the poly-arginine sequence possesses the D-configuration.

Embodiment 33

The method of any one of Embodiments 29, 30, and 32, wherein each residue of the poly-arginine sequence possesses the D-configuration.

Embodiment 34

The method of any one of Embodiments 19-33, wherein the peptide is administered orally, topically, intraaurally, parenterally, intravenously, intra-arterially, subcutaneously, intramuscularly, intracranially, or intranasally.

Embodiment 35

The method of any one of Embodiments 19-34, wherein the peptide is administered topically.

Embodiment 36

The method of any one of Embodiments 19-35, wherein the peptide is administered to the skin, hair, outer ear, tympanic membrane, buccal cavity, nasal cavity, or sublingual cavity.

Embodiment 37

The method of any one of Embodiments 19-36, wherein the peptide is administered to the tympanic membrane.

Embodiment 38

The method of any one of Embodiments 19-37, wherein the peptide is administered in the form of a drop.

Embodiment 39

The method of any one of Embodiments 19-38, wherein the subject is a human.

Embodiment 40

The method of any one of Embodiments 19-39, wherein the peptide is a peptide of any one of SEQ ID NOS: 1-130; 187-316; and 381-396.

The following Embodiments describe methods of the invention.

Embodiment 1

A method of treating noise-induced hearing loss, or treating age-related hearing loss, or improving hearing, the method comprising administering to a subject in need or want of any of the foregoing a therapeutically-effective amount of a peptide that is: a) a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group; or b) a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, and wherein the peptide optionally further comprises a transducing sequence positioned at the C-terminus of the peptide, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing peptides.

Embodiment 2

The method of embodiment 1, wherein at least one amino acid residue of the peptide possesses the D-configuration.

Embodiment 3

The method of any one of embodiments 1 and 2, wherein the transducing sequence is a poly-arginine sequence.

Embodiment 4

The method of embodiment 3, wherein the poly-arginine sequence consists of about nine arginine residues.

Embodiment 5

The method of any one of embodiments 3 and 4, wherein at least one arginine residue of the poly-arginine sequence possesses the D-configuration.

Embodiment 6

The method of any one of embodiments 3-5, wherein each residue of the poly-arginine sequence possesses the D-configuration.

Embodiment 7

The method of any one of embodiments 1-6, wherein the peptide is a peptide of Formula (I).

Embodiment 8

The method of any one of embodiments 1-7, wherein X¹ is A, D, E, K or is absent; X⁴ is A, E, H, I, K, R, or Y; X⁸ is A, F, P, S, T, W, or Y; and X⁹ is A, D, E, or K.

Embodiment 9

The method of any one of embodiments 1-8, wherein cap^(N) is H and cap^(C) is OH.

Embodiment 10

The method of any one of embodiments 1-9, wherein at least one of amino acid residues X¹⁻¹¹ possesses the D-configuration.

Embodiment 11

The method of any one of embodiments 1-10, wherein pep^(N), pep^(C), and tran^(N) are absent, and tran^(C) is the transducing sequence.

Embodiment 12

The method of any one of embodiments 1-6, wherein the peptide comprises: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein the peptide further comprises the transducing sequence, and wherein the transducing sequence is positioned at the C-terminus of the peptide.

Embodiment 13

The method of any one of embodiments 1-6, wherein the peptide is a peptide of any one of SEQ ID NOS: 1-175; 177-361; 363-369; and 378-396.

Embodiment 14

The method of any one of embodiments 1-6, wherein the peptide is a peptide of any one of: SEQ ID NOS: 369; 378; 379; and 380.

Embodiment 15

The method of any one of embodiments 1-14, wherein the peptide is administered orally, topically, intraaurally, parenterally, intravenously, intra-arterially, subcutaneously, intramuscularly, intracranially, or intranasally.

Embodiment 16

The method of any one of embodiments 1-15, wherein the peptide is administered topically.

Embodiment 17

The method of any one of embodiments 1-16, wherein the peptide is administered to the skin, hair, outer ear, tympanic membrane, buccal cavity, nasal cavity, or sublingual cavity.

Embodiment 18

The method of any one of embodiments 1-17, wherein the peptide is administered to the tympanic membrane.

Embodiment 19

The method of any one of embodiments 1-18, wherein the peptide is administered in the form of a drop.

Embodiment 20

The method of any one of embodiments 1-19, wherein the subject is a human.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of noise-induced hearing loss, wherein the compound is a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof, wherein the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of noise-induced hearing loss, wherein the compound is a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing, wherein the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of age-related hearing loss, wherein the compound is a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X^(ii) is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof, wherein the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of age-related hearing loss, wherein the compound is a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing, wherein the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the improvement of hearing, wherein the compound is a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof, wherein the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the improvement of normal hearing, wherein the compound is a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing, wherein the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a compound for use in the treatment of noise-induced hearing loss, wherein the compound is a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof, wherein the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a compound for use in the treatment of noise-induced hearing loss, wherein the compound is a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing, wherein the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a compound for use in the treatment of age-related hearing loss, wherein the compound is a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof, wherein the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a compound for use in the treatment of age-related hearing loss, wherein the compound is a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing, wherein the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a compound for use in the improvement of normal hearing, wherein the compound is a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt thereof, wherein the peptide is not SEQ ID NO: 369 or SEQ ID NO: 378.

In some embodiments, the invention provides a compound for use in the improvement of normal hearing, wherein the compound is a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing, wherein the peptide is not SEQ ID NO: 379 or SEQ ID NO: 380.

In some embodiments, the invention provides a method of treating noise-induced hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof, to a subject in need or want thereof.

In some embodiments, the invention provides a method of treating age-related hearing loss, the method comprising administering a therapeutically-effective amount of a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof, to a subject in need or want thereof.

In some embodiments, the invention provides a method of improving hearing, the method comprising administering a therapeutically-effective amount of a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof, to a subject in need or want thereof.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of noise-induced hearing loss, wherein the compound is a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of age-related hearing loss, wherein the compound is a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the improvement of hearing, wherein the compound is a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof

In some embodiments, the invention provides a compound for use in the treatment of noise-induced hearing loss, wherein the compound is a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof.

In some embodiments, the invention provides a compound for use in the treatment of age-related hearing loss, wherein the compound is a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof.

In some embodiments, the invention provides a compound for use in the improvement of hearing, wherein the compound is a peptide of any one of SEQ ID NOS: 369 and 378-380, or a pharmaceutically-acceptable salt thereof.

In some embodiments, the invention provides a use of a compound in the preparation of a medicament for the treatment of noise-induced hearing loss, or treating age-related hearing loss, or improving hearing, wherein the compound is a peptide that is: a) a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁰ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group; or b) a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, and wherein the peptide optionally further comprises a transducing sequence positioned at the C-terminus of the peptide, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing peptides.

In some embodiments, the invention provides a compound for use in the treatment of noise-induced hearing loss, or treating age-related hearing loss, or improving hearing, wherein the compound is a peptide that is: a) a peptide of Formula (I) or Formula (II),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (I),

(cap^(N))(cap^(N))N-tran^(N)-pep^(N)-(X¹²-X¹¹-X¹⁰-X⁹-X⁸-X⁷-X⁶-X⁵-X⁴-X³-X²-X¹)_(x)-pep^(C)-tran^(C)-C(O)-cap^(C)  Formula (II), wherein

each cap^(N) is independently H, alkyl, aryl, aralkyl, an acyl group, an alkoxycarbonyl group, an aryloxycarbonyl group, or an aminocarbonyl group, or both cap^(N) groups together with N form a heterocycle; tran^(N) and tran^(C) are each independently a transducing sequence or absent; pep^(N) and pep^(C) are each independently an amino acid sequence or absent; X¹ is A, K, an acidic amino acid residue, or is absent; X² is A, I, L, or V; X³ is A, D, I, L, P, or V; X⁴ is A, E, I, Y, or a basic amino acid residue; X⁵ is A, I, L, or V; X⁶ is A, G, S, T, or Y; X⁷ is A, E, I, L, or V; X⁸ is A, P, S, T, or an aromatic amino acid residue; X⁹ is A, K, or an acidic amino acid residue; X¹⁶ is A, C, M, S, α-aminobutyric acid, or norvaline; X¹¹ is A, I, L, V, or is absent; X¹² is G or is absent; x is 1, 2, or 3; cap^(C) is OH, alkoxy, aryloxy, arylalkoxy, amino, alkylamino, dialkylamino, or a heterocycle; and each amino acid residue side chain is independently optionally capped with a capping group; or b) a peptide comprising: IGLCA (SEQ ID NO: 207); YIKVQ (SEQ ID NO: 227); LFNEI (SEQ ID NO: 252); EMFTI (SEQ ID NO: 276); YRGLL (SEQ ID NO: 287); RIKYG (SEQ ID NO: 304); or EEYFM (SEQ ID NO: 305), wherein each terminus and each amino acid residue side chain of the peptide is independently optionally capped with a capping group, and wherein the peptide optionally further comprises a transducing sequence positioned at the C-terminus of the peptide, or a stereoisomer or pharmaceutically-acceptable salt of any of the foregoing peptides.

REFERENCES

The following references, and those cited in the disclosure herein, are hereby incorporated by reference herein in their entirety.

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1-20. (canceled)
 21. A method of improving hearing, the method comprising administering to a subject in need or want thereof a therapeutically-effective amount of a peptide comprising SEQ ID NO: 369, wherein the side chain of each amino acid residue of the peptide is independently uncapped or capped with a capping group, or a stereoisomer or pharmaceutically-acceptable salt of the peptide.
 22. The method of claim 21, wherein the peptide further comprises a transducing sequence at the C-terminus of the peptide.
 23. The method of claim 22, wherein the transducing sequence is a poly-arginine sequence.
 24. The method of claim 22, wherein the transducing sequence is nine consecutive arginine residues.
 25. The method of claim 21, wherein the administration increases the subject's ability to hear by at least 5 decibels.
 26. The method of claim 21, wherein the administration increases the subject's ability to hear by at least 20 decibels.
 27. The method of claim 21, wherein the administration increases the subject's ability to hear by at least 40 decibels.
 28. The method of claim 21, wherein the therapeutically-effective amount is from about 100 ng per kg of subject body mass to about 10 mg per kg of subject body mass.
 29. The method of claim 21, wherein the administration is topical.
 30. The method of claim 21, wherein the administration is to a tympanic membrane of the subject.
 31. The method of claim 21, wherein the administration is in the form of a drop.
 32. The method of claim 21, wherein the administration is in the form of an aerosol, vapor, spray, or mist.
 33. The method of claim 21, wherein the administration is in the form of an ointment, cream, liquid, gel, or salve.
 34. The method of claim 21, wherein the peptide is SEQ ID NO:
 369. 35. The method of claim 21, wherein the peptide is SEQ ID NO:
 378. 36. The method of claim 21, wherein the peptide is SEQ ID NO:
 183. 37. The method of claim 21, wherein the peptide is SEQ ID NO:
 184. 38. The method of claim 21, wherein the peptide is SEQ ID NO:
 185. 39. The method of claim 21, wherein the peptide is SEQ ID NO:
 186. 40. The method of claim 21, wherein the subject is a human. 